Coeliac dis­ease af­fects one in 100

Bray People - - LIFESTYLE - YOUR HEALTH WITH DR. MICHELLE COOPER

ABOUT ONE in ev­ery 100 people in Ire­land is af­fected by coeliac, which is caused by a re­ac­tion of the gut to gluten, re­sult­ing in in­flam­ma­tion within the lin­ing of the small in­tes­tine. This in­flam­ma­tion sub­se­quently means food and nu­tri­ents can­not be read­ily ab­sorbed by the body.

Coeliac dis­ease is not a food al­lergy or in­tol­er­ance, but an au­toim­mune dis­ease. This means the im­mune sys­tem, which nor­mally pro­tects the body from in­fec­tions, mis­tak­enly at­tacks it­self.

The cause is sen­si­tiv­ity to gluten. Gluten oc­curs in ev­ery­day foods con­tain­ing wheat, bar­ley and rye, such as bread, pasta and bis­cuits. Some people with coeliac dis­ease are also sen­si­tive to oats. In people with coeliac dis­ease, the body pro­duces an­ti­bod­ies against gluten and these an­ti­bod­ies lead to in­flam­ma­tion de­vel­op­ing in the lin­ing of the small in­tes­tine.

Coeliac dis­ease is most com­monly di­ag­nosed in people be­tween the age of 40 and 50 years. It is not known why the im­mune sys­tem may sud­denly be­come sen­si­tised to gluten but coeliac dis­ease of­ten runs in fam­i­lies and is more com­mon in people who have other au­toim­mune dis­eases.

SYMP­TOMS

* Chil­dren: Symp­toms may first de­velop soon af­ter wean­ing when a baby starts eat­ing solid foods con­tain­ing gluten. As food is not be­ing ab­sorbed prop­erly, stool may be pale and bulky and may also be smelly and dif­fi­cult to flush away. Di­ar­rhoea may even oc­cur. The tummy may be­come swollen and re­peated vom­it­ing may oc­cur. Symp­toms, how­ever, may not be en­tirely ob­vi­ous. The first thing that may be no­ticed is poor growth.

* Adults: Poor ab­sorp­tion of food may cause de­fi­cien­cies of vi­ta­mins, iron, and other nu­tri­ents. Anaemia due to poor iron ab­sorp­tion is com­mon. Other symp­toms in­clude ab­dom­i­nal pains, ex­cess wind, bloat­ing, di­ar­rhoea and tired­ness or weak­ness. Mouth ul­cers may oc­cur. You may lose weight due to poor ab­sorp­tion. How­ever, most adults with coeliac dis­ease do not lose weight and are not un­der­weight.

“Coeliac dis­ease is not a food al­lergy or in­tol­er­ance, but an au­toim­mune dis­ease”

DI­AG­NO­SIS

If coeliac dis­ease is sus­pected, a blood test to de­tect a cer­tain an­ti­body may be or­dered by your doc­tor. It is im­por­tant that gluten is be­ing con­sumed for at least six weeks be­fore the blood test. If pos­i­tive, you may then be re­ferred to a specialist for a con­fir­ma­tory biopsy.

TREAT­MENTS

* Gluten free diet: Gluten needs to be avoided for the rest of your life. The symp­toms usu­ally go within a few weeks of omit­ting gluten from your diet. Spe­cial gluten free flour, pasta, bread and other foods are widely avail­able. There are many diet sheets with food al­ter­na­tives and recipes avail­able.

* Vi­ta­mins: You may be ad­vised to take cer­tain vi­ta­mins, cal­cium and iron sup­ple­ments for the first six months fol­low­ing di­ag­no­sis.

* Im­mu­ni­sa­tions: You may be ad­vised to have the flu jab as well as the pneu­mo­coc­cal vac­cine. This is be­cause your spleen works less ef­fec­tively, mak­ing you more vul­ner­a­ble to in­fec­tion.

COM­PLI­CA­TIONS

People with coeliac dis­ease can have an in­creased risk of de­vel­op­ing os­teo­poro­sis, lym­phoma and pre­ma­ture de­liv­ery if preg­nant. There are also risks of de­vel­op­ing other au­toim­mune re­lated ill­nesses. The like­li­hood of de­vel­op­ing these ill­nesses re­duces when coeliac pa­tients re­frain from eat­ing gluten.

Fur­ther in­for­ma­tion is avail­able from the Coeliac So­ci­ety of Ire­land's web­site; www.coeliac.ie

Wheat prod­ucts can se­verely af­fect people with coeliac dis­ease

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