coeliac disease-nutritionAlternative Names
coeliac sprue, gluten-sensitive enteropathy, non-tropical sprue
Coeliac disease is a chronic digestive disorder that affects the small intestine. It can begin at any stage of life, from infancy through adulthood. The disease varies in severity from person to person. People with coeliac disease have an intolerance or a reaction to gliadin, which is a component of gluten. Gluten and gliadin are found in several common grains.
What food source is the nutrient found in?
Gluten is found in wheat, rye, barley, oats, and triticale. So, the diet for coeliac disease is actually known as gluten-free. People with the disease cannot eat wheat, rye, barley, triticale and oats or any products made with these grains. Oats have traditionally been considered off-limits to people with this condition. However, recent studies have challenged this, and experts may tell people with coeliac to try oats on a case-by-case basis. Oats are not recommended in Australia due to the possible cross contamination with other grains.
How does the nutrient affect the body?
In people with this disease, gliadin damages the tiny projections, called villi, that cover the lining of the small intestine. Villi absorb and carry fluids and nutrients. When they are damaged, the body is unable to take in the nutrients that it needs. This causes problems that include:
In adults, common symptoms may include mouth ulcers, bloating, fatigue and anaemia. It also can cause vitamin and mineral deficiencies, lactose intolerance, and a foul smell to faeces.
- weight loss
- distended belly
Diet is an important part of treating this condition. A person with coeliac disease is put on a gluten-restricted, gluten-free diet. If he or she is very careful, most vitamin and mineral levels will return to normal without supplementation.
Foods to avoid are any products made with wheat, rye, triticale, oats and barley. These starches are found in many flours and thickening agents. Many processed foods also have hidden sources of gluten and gliadin. People with coeliac disease should learn to read food labels to look for hidden gliadin-containing ingredients. Foods such as corn, rice, soybeans, chickpeas, tapioca, arrowroot, buckwheat and legumes are eaten instead. It also can be helpful to cut back on lactose, a milk sugar found in most dairy products in the early weeks after diagnosis.
A person with this disease may need to supplement his or her diet with vitamin and minerals, including calcium and vitamin D, and electrolyte and fluid replacement.
The cause of coeliac disease is not completely known. One theory suggests that it is due to a missing or poorly functioning enzyme of the immune system. Other theories suggest it may be genetic. "Recovery" from this disease may take as long as 6 months to several years on a gluten-free diet. After this time, symptoms will largely disappear and the small intestine will return to normal. The disease and dietary treatment remain for life. Once a coeliac, always a coeliac.
People with coeliac disease must also be careful that gliadin foods do not come into contact with other foods during preparation. This can easily happen in the cases of shared utensils, cutting boards, or containers. This problem can make eating out hard for those with the disease.
The good news is that people with coeliac are not alone. There are many groups that provide resources for these people and their families. There are also more choices today than ever before for gluten-free foods. At one time, people with coeliac disease had to make many of their own foods. They commonly made bread from potato flour and cereals from non-gluten grains. Now there are large food companies that produce pasta, breads, and cereals made from gluten-free grains. Remember, a life long gluten free diet is the only treatment for coeliac disease.
These organisations can provide information and resources: Go to this site for contact addresses for each state.
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 13/1/2005
Potential conflict of interest information for reviewers available on request