Coeliac Disease

Coeliac disease is a lifelong autoimmune condition caused by an adverse reaction to a food protein called gluten, which is found in wheat, barley and rye. When gluten is eaten, the body’s immune system attacks and damages its own tissues, leaving the gut inflamed. This can lead to a range of symptoms and nutritional problems.

Is there a Cure for Coeliac Disease?

While there is no cure for coeliac disease, following a strict gluten-free diet and avoiding gluten-containing foods can eliminate symptoms and the development of serious complications.

Coeliac Disease commonly manifests with gastrointestinal symptoms, although it can also induce a wide range of nonspecific signs and complaints. Symptoms of coeliac disease can include bloating, diarrhoea, tiredness, abdominal pain, anemia and weight loss which result from eating foods containing gluten.

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Coeliac disease can occur at any age. Because there is a significant genetic factor, it is frequently passed down through generations in a family.

Coeliac disease affects approximately 1 in every 100 people. This ratio varies, however, from country to country. In order to be diagnosed with Coeliac Disease you must still be eating gluten, so it’s important not to drop from your diet until you have had the Coeliac tests.

Research suggests that the number of people affected is growing, although this might be due to greater public awareness and testing.

Awareness and visibility have helped improve the lifestyle of people with a diagnosis of Coeliac Disease. Food labelling must now include gluten as an ingredient if there are even trace amounts of it in the packaged food.

In the last ten years, the resources and foods available for people with Coeliac Disease have increased dramatically. There is now a wider range of gluten-free foods produced commercially, and increased online availability of gluten free recipes.

Long Term Health Issues

The small intestine of a person with coeliac disease becomes inflamed, limiting the absorption of critical vitamins and minerals such as iron, folic acid, calcium, and fat-soluble vitamins from food.

Initial tests for the coeliac disease include searching for anti-tTG and a total IgA level. The best method for diagnosis is a duodenal biopsy.

A diet based on gluten-free food is typically sufficient to ensure complete remission. The tolerance levels for gluten vary from person to person. Some people are extremely sensitive to even small amounts of foods that contain gluten and become very ill with just a trace.

Coeliac Disease can lead to a higher risk of long-term health issues such as osteoporosis and bowel cancer if the person doesn’t move to a gluten-free diet.

Recent Research

A Canterbury study suggested that Coeliac disease affects about two females to every one male. Coeliac disease affects people of all races, but it is relatively uncommon in black Africans and those of Chinese or Japanese heritage. There is little data on prevalent rates of coeliac disease in Maori, although it is generally thought to be lower than that of Europeans in New Zealand.

Coeliac disease is underdiagnosed owing to the varied manner in which those with coeliac disease can present symptoms to their doctor. Coeliac disease is marked by intestinal inflammation, which affects the small intestine and causes malabsorption, steatorrhea (floating stools), abdominal discomfort, bloating and in some cases, weight loss.

Symptoms that mimic those of irritable bowel syndrome are common, and many gastroenterologists test people who exhibit signs of irritable bowel syndrome for Coeliac Disease as a matter of course.

Coeliac Disease is diagnosed in children as a result of symptoms and blood tests, but it is thought that the condition was silent or unrecognised during childhood for those diagnosed as adults.

Comorbidities and Conditions

Coeliac disease is more prevalent in those with the following conditions and/or situations.

  • Type one diabetes (risk is 1 in 20)
  • Osteoporosis
  • Infertility or recurrent miscarriage
  • Autoimmune thyroid disease
  • Unexplained liver disease
  • Addison’s disease
  • Unexplained neurological disease (particularly peripheral neuropathy, ataxia, and epilepsy)
  • Dermatitis herpetiformis
  • Down Syndrome and Turner Syndrome
  • Sjogren’s syndrome
  • Primary biliary cirrhosis.

“I initially went to Rosanne for my breastfed son who was screaming for hours daily with awful tummy pains and unusual bowel motions. Thanks to Rosanne’s gut healing plan for both of us, my sons’ symptoms have gone and he has became a happy healthy boy. My own health has improved greatly, my stomach is comfortable with no more bloating or cramps, I have more energy and my skin is clearer. I can’t thank Rosanne enough for improving myself and my sons’ health so dramatically.”

- Emily Dickson -

Tests and Diagnosis for Coeliac Disease

To diagnose nutritional deficiencies, various standard blood tests are performed at the time of diagnosis. Tests are performed to search for suboptimal levels of Vitamin B12, Folate, Haemoglobin, LFTa, Vitamin D, Calcium and Iron levels.

Treatment for Coeliac disease is based on permanently removing gluten from the diet and sticking to gluten-free foods. Adherence to dietary advice and a gluten-free diet remains the most important step in coeliac disease management, which includes all foods containing wheat, rye or barley, and for those who are particularly sensitive, any grains or foods that are produced in gluten processing facilities.

Gluten is also ‘hidden’ in a number of foods you might not suspect, such as soy sauce, so reading labels really makes a difference in the management of this condition.

Frequently Asked Questions About Coeliac Disease

What is ‘nonceliac gluten sensitivity,’ or ‘NCGS’

Coeliac disease is not the same as gluten sensitivity or intolerance. These conditions are often confused with one another but are quite different. Gluten sensitivity or gluten intolerance is referred to as ‘non-coeliac gluten sensitivity,’ or ‘NCGS’. People with NCGS do not show elevated inflammation markers in their blood tests, and they don’t have the antibodies that people with coeliac produce.

Sufferers of NCGS, however do experience remarkably similar gastrointestinal symptoms such as constipation, bloating, gas, and diarrhoea, as well as non-GI symptoms such as brain fog, joint pain, and neuropathy.
A lab test is also not able to confirm NCGS. NCGS would likely be diagnosed based on a negative coeliac test result when symptoms appear after consuming gluten-containing food, and that goes away once a patient maintains a gluten-free diet.

How common is coeliac disease in New Zealand?

Coeliac disease is a common disorder and is believed to affect about 1 out of every 100 people, although it’s suspected as many as 4 out of 5 people may have the condition but not be aware of it.

Tests for Coeliac Disease Used in Diagnosis

Blood tests measure antibody levels in the blood, which are elevated in people with untreated coeliac disease.

If Coeliac antibodies are elevated, this will be followed by a small bowel biopsy. A diagnosis of Coeliac disease will be confirmed if the biopsy shows damage to the villi of the small intestines.

This involves a gastroscopy procedure in which several tiny samples (biopsies) of the small bowel are taken. The endoscopy takes about 10 minutes in a simple day procedure under light anaesthetic sedation. For children, a short general anaesthetic is required, and it is usually done as a day case. Biopsies are then examined to confirm the presence of villous atrophy.

Coeliac disease is associated with genetic markers known as HLA DQ2 and HLA DQ8, which can be tested with a simple blood test. This can be a very helpful test when the diagnosis is uncertain because a negative test more or less rules out coeliac disease. This is because more than 95% (and perhaps as many as 99%) of people with coeliac disease will have one or other of these markers. However, a positive HLA test is not enough to confirm that a person has coeliac disease because between 30% and 50% of the population who will never develop the disease also have this gene.

Staying on a Normal Gluten-Containing Diet Before Testing

This is vital in the lead-up to testing, as coming off gluten will affect the results. Although a gluten-containing diet is not needed for the gene test, if a person tests positive for the affected genes, a ‘gluten challenge’ followed by a small bowel biopsy will be needed to correctly diagnose coeliac disease.

Coeliac Disease in Children

The symptoms of Coeliac Disease vary widely depending on the age at which it’s first diagnosed.

In children between nine months and two years, there can be a delay in weight gain.

Anorexia, irritability, changes in stool frequency and consistency, abdominal distention, and vomiting are some possible symptoms that might then appear.

A review of patients who were diagnosed with Coeliac Disease at the Starship Hospital in New Zealand recently revealed a median age of 6.9 years.

An older child with coeliac disease is more likely to experience stomach aches, constipation, intermittent loose stools, tiredness, mouth ulcers, vomiting, and a lack of appetite after eating gluten, delayed puberty in girls or acne. 

How do I support my child with Coeliac Disease?

You can  prepare many gluten-free dishes by substituting different components (such as stock cubes) while cooking for the family.

It’s important to take precautions against gluten cross-contamination in the kitchen. For example, adults or children with coeliac disease should have their own toaster.

Adjusting to a Diagnosis of Coeliacs Disease in Your Child

  • Teaching your youngster about coeliac disease
  • Involving the entire family
  • Cooking from scratch for the entire family
  • Regular check-ups are recommended
  • Communicating the condition to your child’s school
  • Research gluten-free options
  • Introduce new gluten-free recipes

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Do you suspect you may have Coeliac Disease? Rosanne can make a profound difference.