Gluten Free Tips

Coeliac disease is caused by an intolerance to gluten, a protein found in wheat and rye (and something similar in barley and possibly oats). This immune reaction to antigenic factors damages the mucosal lining of the small intestine, flattening the villi and reducing its ability to absorb nutrients.

The resulting symptoms of malabsorption which occur in varying degrees, may be acute
– steathorrhea, diarrhoea and abdominal discomfort, or more chronic
– tiredness, irritability and unexplained weight loss or failure to thrive in children.
The intolerance requires complete, life-long exclusion of gluten from the diet.

The peak age of onset of coeliac disease is now between 40 and 50 years, with increasing numbers of people being diagnosed in later life. The disease is more common in women than men by almost 3:1 in middle aged adults

Much remains to be learnt about how or why gluten harms the intestine. Gluten intolerance can also result in a skin disorder, dermatitis herpetiformis, which may or may not be associated with intestinal damage but is less likely to result in gastrointestinal symptoms.

A gluten-free diet is a major undertaking and always requires expert dietetic advice

It can take several months of gluten avoidance before the gut mucosa and villi return to normal and a year before previously impaired blood biochemistry improves

Complete and permanent avoidance of gluten is essential to reduce the risk of bowel malignancy and other long terms consequences of the disease.

Not to be confused with coeliac disease, wheat may provoke allergic reactions (delayed type IV) or chronic gastrointestinal symptoms of intolerance with no obvious immunological basis. Wheat allergy or intolerance will require total wheat exclusion though partial exclusion may suffice for those with a non-immunologically mediated form of intolerance for whom there seems to be a threshold of sensitivity. Commercially wheat free (and gluten-free) products are not prescribable for wheat allergy/intolerance per se.