Understanding coeliac disease

There are now many gluten-free products on the market to cater for people with coeliac disease. Photo / Te Awamutu Courier

Coeliac disease may be one of the most common chronic diseases in the world, affecting around one per cent of the population. A New Zealand study showed it is as common as 1 in 83 in Canterbury - this is one of the highest rates in the world - 1.2 per cent.

According to an international source, there are estimated to be up to 14,000 undiagnosed coeliacs in New Zealand.

This week is Coeliac Awareness Week - the level of awareness of this condition is still generally low.

Coeliac disease is an autoimmune disease where eating gluten-containing grains causes antibodies to attack the gut. This condition can also affect the whole body.

It is inherited genetically, and seems to be more common in females.

Within families, it is commonly inherited along with other autoimmune diseases, including thyroid problems, Type 1 diabetes, rheumatoid arthritis, lupus, psoriasis, Crohn's disease and multiple sclerosis.

Other conditions that can have associations with coeliac disease include epilepsy and neurological disorders, alopecia (hair loss), anxiety, depression, arthritis, ADHD, autism and headaches or migraines.

The commonest reasons adults may be checked for coeliac disease are because they have anaemia, irritable bowel syndrome, thyroid problems or osteoporosis, as well as a family history of coeliac disease.

The most common reason a child would be tested for it would be if he or she was not growing.

Its very important to diagnose coeliac disease early because the treatment is simple (avoiding gluten-containing foods), and you can prevent many health problems that it causes.

Gluten is a protein found in wheat, barley, Rye and oats. People with coeliac disease can't eat cereals, bread, pasta, some processed foods and beer.

A person who tests positive for coeliac disease should still be treated even if they have no symptoms.

You should consider yourself at higher risk of coeliac disease if, in addition to the above conditions, if you have had:

* Many gut symptoms
* A family history of coeliac disease
* Persistent gut problems - pain, bloating
* Persistent iron or folic acid deficiency
* Type 1 diabetes (5 per cent of Type 1 diabetics have coeliac disease)
* Selective IgA deficiency
* A skin condition called dermatitis hepatiformis

WHAT IS IMPORTANT

* Coeliac disease can exist with no symptoms.

* There appears to be a spectrum of tolerability of gluten amongst people who do not have coeliac disease. Gluten-containing foods can be irritable to the gut, therefore some people who do not have coeliac disease may still feel better when they avoid gluten.

* The good news now, is that there are many gluten free options available in shops and restaurants.

* Testing for coeliac disease looks for antibodies to gluten-related proteins in a blood test.

* A Bowel Biopsy is considered the Gold Standard test but none of the tests are 100 per cent reliable, so if you think you have coeliac disease despite negative tests, you can ask your family doctor or gastroenterologist for a gene test - if the gene test is negative, it's 100 per cent reliable that you haven't got coeliac disease.

* For further information see the website of the NZ Celiac Society.

- Dr Frances Pitsilis
drfrances.co.nz

Pictured above: There are now many gluten-free products on the market to cater for people with coeliac disease. Photo / Te Awamutu Courier