Coeliac Disease

Published: 17 Mar 2016

Coeliac Disease

It’s Coeliac Awareness Week!!  Condolences to you gluten challenged peeps!  Since gluten (along with sugar) seems to be a trendy thing to quit right now (without a medical reason) I thought it was worth having a look a bit more deeply at gluten and Coeliac Disease.

Coeliac disease is not the same as wheat allergy.  Coeliac disease isn’t an allergy at all it is an autoimmune disease. 

Autoimmune diseases arise from an abnormal immune response to substances and tissues that are normal within the body.


In coeliac disease the immune system produces antibodies that attack the lining of the bowel.  The trigger for this is gluten, a protein found in wheat, rye, barley, triticale and oats.  Gluten is what makes dough elastic and gives bread its chewiness. This is why gluten free pasta is fairly ok but gluten free bread is often disappointing.

The tiny, finger-like projections that line the bowel (villi) become inflamed and flattened. This is referred to as villous atrophy. Villous atrophy reduces the surface area of the bowel available for nutrient absorption, which can lead to gastrointestinal and malabsorptive symptoms. Symptoms can also be caused by inflammation in other parts of the body.

Symptoms (as listed by The Coeliac Society)

  • gastrointestinal symptoms e.g. diarrhoea, constipation, nausea, vomiting, flatulence, cramping, bloating, abdominal pain, steatorrhea
  • fatigue, weakness and lethargy
  • iron deficiency anaemia and/or other vitamin and mineral deficiencies
  • failure to thrive or delayed puberty in children
  • weight loss (although some people may gain weight)
  • bone and joint pains
  • recurrent mouth ulcers and/or swelling of mouth or tongue
  • altered mental alertness and irritability
  • skin rashes such as dermatitis herpetiformis
  • easy bruising of the skin

Coeliac disease affects at least 1 in 100 Australians. However approximately 75% currently remain undiagnosed.

Increasing numbers of people are being diagnosed with coeliac disease.  This is due to both better diagnosis rates and a true increase in the incidence of coeliac disease.  Unfortunately the only way to manage coeliac disease effectively is strict avoidance of gluten.

For some reason, in the last few years, it has become very trendy to go “gluten free” for no particular medical reason.  This has happened along side the increasing popularity of the “paleo” diet and “clean eating”.  The hashtag #glutenfree appears over 8 million times on Instagram!

There is no nutritional harm in unnecessarily cutting gluten out of the diet, however it is in some of our favourite foods like bread, pasta, pizza, cake so it can make like a little less pleasant.  However cutting out gluten makes it impossible to properly diagnose coeliac disease, for a complete and accurate diagnosis you must still be eating gluten-containing foods.

If you or your child is suffering from any or many of the symptoms in the list above, see your GP.  It is very important to rule out coeliac disease as well as inflammatory bowel conditions and common illnesses before cutting gluten out of the diet.

If any of these medical conditions are diagnosed and you need to change your diet, see an accredited practicing dietitian

Coeliac Ingredients

Processed foods are trickier to navigate. However food manufacturers are now required to declare (in bold) potential allergens on the ingredients list, as shown here.

to ensure your diet remains nutritionally balanced.  A dietitian can also teach you how to read labels to ensure the gluten avoidance is complete, this is very important to ensure bowel healing.

Taking gluten out of the diet is usually quite overwhelming to start with; it can be helpful to remember many staple foods are naturally gluten free.  All unprocessed meats, fresh vegetables and fruits and dairy are gluten free.  Even if animals have been grain fed their eggs and meat is still gluten free.  Rice, corn, potato and sweet potato are the easiest starchy staples to replace gluten-containing grains with.

As coeliac disease is becoming more frequently diagnosed and with the rising trend that is “gluten free” the availability of gluten free foods has increased too.  So perhaps we should say thanks to the paleo hipsters!