What is coeliac disease?
In Australia, coeliac disease (CD) affects 1 in 250 Australians.1,4 It is a condition whereby the lining of the small intestine in genetically predisposed individuals has a permanent intolerance to dietary gluten. Gluten is a protein found in wheat, barley, rye and triticale.
Gluten ingestion leads to inflammation of the small intestine mucosa, and consequent villous atrophy of the mucosal layer. This means that the mucosal layer’s normally undulating surface is flattened, resulting in a reduced surface area for nutrient absorption.
Risks associated with coeliac disease
Patients with CD have a higher than usual risk of the following conditions and disorders.1
- Sub-optimal nutrient absorption eg. protein, fat, CHO, iron, calcium, magnesium, zinc and vitamins
- Low nutritional status, leading to conditions such as anaemia and osteoporosis
- Increased risk of malignancy
- Female infertility and recurrent miscarriage
- Insulin-dependent diabetes (Type 1 diabetes)
- Dermatitis herpetiformis
- Autoimmune thyroid disease
- Neurological disorders, such as ataxia and epilepsy
- Liver disorders
- Peripheral neuropathy
Treatment
CD is treated by a lifelong removal of gluten from the diet.3,4 This allows the mucosal lining of the small intestine to recover and the associated symptoms and deficiencies to resolve. Reinclusion of gluten at any stage will cause recurrence of intestinal damage.
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References
1. The Gut Foundation (2004). Coeliac disease: food allergy & intolerance. The Gut Foundation: Randwick, NSW.
2. RPAH Allergy Unit (2004). Coeliac disease: Enjoy life gluten-free. RPAH Allergy Unit, Camperdown, NSW. allergy@email.cs.nsw.gov.au
3. Branski D., Troncone R. (1998) Coeliac disease: a reappraisal. The Journal of Pediatrics 133:181-187.
4. The Coeliac Society of Australia. www.coeliac.org.au