Bytheway... Could YOU have coeliac disease too?
DIGESTIVE issues are common in today’s society. Menus often come with a list telling us who should avoid what, and diners scrutinise it with military precision, as the potential for contamination is huge in a commercial kitchen.
I remember a ‘gluten-intolerant’ colleague at medical school who was rendered incapacitated by a crouton. It seemed ridiculous at the time — but we soon learned that he had coeliac disease, an autoimmune condition where the immune system mistakes substances found inside gluten as a threat to the body and attacks them. We realised that regular student fodder of pints, pizzas and pasta resulted in our classmate suffering from painful cramps, bloating and wind.
He spent ages in the toilet, was always tired and had recurrent mouth ulcers. He realised that he had to go strictly gluten-free if he wanted to live a healthy life. Five years after graduation, I bumped into him and he was barely recognisable as the pasty-faced lad I used to know.
I felt bad that, as trainee doctors, we hadn’t done more for him. In fact, we often just felt he was little more than a fussy eater.
Well, this week is Coeliac Awareness Week, highlighting a disease that impacts one in 100 people here. The disease can be passed down the family tree — ten per cent of those with a first-degree relative who is a coeliac will be similarly affected, with the figure rising to 70 per cent in the case of identical twins. It’s a distinct diagnostic possibility if you have lived with a lifetime of badly behaving bowels — many patients go undiagnosed.
We are seeing more and more adult diagnoses of this disease than ever before. Women seem to suffer twice as much as men, with many being misdiagnosed with irritable bowel syndrome (IBS), food intolerances or hormonal bloating before they get tested. A simple blood test has revolutionised the screening process for this disease, so it can be done at your GP’s, though you still need to be eating gluten for the test to work properly.
Is it a big deal if you don’t get diagnosed or you self-diagnose? Yes — coeliac disease is serious. It’s not just about the gut and avoiding wheat, barley and rye. It can result in anaemia, vitamin deficiencies, infertility and osteoporosis. And, as an autoimmune condition, it puts you at risk of a host of other autoimmune diseases by default. Patients with coeliac disease are at greater risk of colon cancer.
Get a diagnosis if you suspect something is wrong. If you are diagnosed and told to avoid gluten, make sure you do. It may be a disease that can’t be cured, but it is easily curtailed. ÷SEE coeliac.ie