Coeliac Disease

What you can and cannot eat and some yummy recipes

What is Coeliac Disease?

Coeliac disease is a chronic disorder of the intestine due to <em>gluten intolerance</em>, which greatly reduces the body’s ability to absorb nourishment. It can have drastic consequences if not managed properly through diet. The walls of the small intestine become inflamed and damaged so that food absorption practically stops, giving rise to nutritional deficiencies.

Symptoms: These are often both vague and various, but may include any of the following: abdominal pain and discomfort with gassy distension, fatigue, lethargy, loss of appetite, weakness, diarrhoea, vomiting, anaemia and other signs of malnutrition. The disease usually presents in infancy at weaning time, but can manifest itself at any age for no apparent reason.

Causes and occurrence: One of the main causes is undoubtedly the early introduction of solids, particularly wheat, to a baby’s diet. The body’s ability to digest complex carbohydrates such as those found in cereal grains is rarely developed before the age of six months. The disease is particularly prevalent in Ireland and this may be linked with the increasingly common, but ill-advised practice of early weaning in this country.

Diagnosis: Definitive diagnosis is by means of a biopsy to assess the level of damage to the walls of the small intestine. However, if you suspect you are suffering from gluten intolerance or Coeliac Disease, you could experiment by omitting all gluten-containing foods from your diet and very gradually reintroducing them, one grain at a time. If symptoms recur you should report your findings to your doctor, who can make a definitive diagnosis. It is also possible that you may be intolerant of one or more particular grains. Wheat intolerance is particularly common. This is not Coeliac disease, but it can result in many similarly uncomfortable symptoms.

Management and treatment: Coeliac Disease is a permanent condition, but full recovery from the symptoms can be achieved by the exclusion of all gluten-containing foods. Good health can be maintained by following a whole food diet, excluding highly processed and refined foods, and by using the wholesome and naturally gluten free flours now widely available in health stores.

What you cannot Eat

Most of the grains, namely wheat, rye and barley, and all processed foods which may contain those grains or their derivatives. These are found in a very wide range of foods, e.g. soups, sauces, gravies, condiments, some spices, salad dressings, even ice cream, and in all almost all convenience, frozen or fast foods. Great care must be taken, therefore, when reading labels, as even the smallest trace of gluten usually sets off the symptoms again. Ingredients, which contain gluten, include starch, modified starch, rusk, hydrolized vegetable protein, bran and wheatgerm and wheatgerm oil. “Gluten-free flour” is usually de-glutenised wheat flour and is best avoided in favour of flours which are naturally free of gluten (see below).

What you can Eat

Everything else! By becoming familiar with new ingredients and different cooking methods you can easily make your gluten free diet interesting and wholesome, with more variety than the average person. All fruit and vegetables, pulses, nuts and dairy products are suitable, meat and fish in their pure state (not processed), and some grains such as bread, biscuits, rice cakes, pasta, cereals, flours and a wide variety of convenience gluten-free foods. However it should be borne in mind that a good wholefood diet with plenty of seasonal fruit and vegetables (preferably), and keeping the convenience or packaged foods to a minimum is the best way back to optimum health. As the more insidious effects of Coeliac Disease arise from malnutrition, a good tonic or vitamin supplement may also be advised, but do make sure it is gluten-free.

Don’t forget that your IAHS store probably has books, pamphlets and recipe leaflets for glutenfree diets and trained staff are always on hand to help and advise.

Know your Gluten Free Flours

A number of naturally gluten-free flours are listed below and are all to be found in your IAHS store. Please note that these flours have different baking properties to ordinary flour due to the of gluten (which gives a bread dough a certain elasticity, helping it to rise), and so need different baking techniques. For example, bread is made as a batter, and biscuits and pastry turn out less crumbly if kneaded and left in the fridge for half an hour before use. Don’t forget to use gluten-free baking powder.

This fact sheet is for information only and is not meant to be used for self-diagnosis or as a substitute for consultation with a healthcare professional.