Coeliac Disease is an autoimmune condition which requires lifelong avoidance of the protein gluten.
Download a PDF version of this article
Gluten is found in the cereals wheat, rye and barley, and all their derivatives. Gluten is not found in oats, however, oats are often produced in factories which process cereals containing wheat so it’s important to choose gluten free oats.
When requesting the appropriate tests to diagnose coeliac disease, it is important that to have a regular source of gluten in the diet before the test. This means about 4 slices of bread per day for an adult or 2 for a child. Gluten needs to be present for about 6 weeks before testing to obtain reliable results.
People with a confirmed diagnosis even if there aren’t any symptoms, should fgluten-freeten free diet. Coeliac disease is not a matter of tolerance levels and continued inclusion increases the risk of morbidity of osteoporosis, malignancy, sub-fertility and general poor nutritional status.
Cross contamination is often an issue – using separate utensils such as toasters and chopping boards is important.
Did you know that:
A positive HLA-DQ2/8 is not diagnostic of coeliac disease (as half the general population is positive) but a negative HLA-DQ2/8 is a strong negative predictor (less than 1% likelihood of coeliac).
A positive tTG – IgA along with positive DGP –IgA still requires a small bowel biopsy for diagnosis.
Usual symptoms might present such as anaemia, lethargy, GI upsets but patients can also be asymptomatic. Coeliac can also develop at any stage in life and 1st degree relatives have a 10% + chance of also being affected by coeliac disease.
Author: Jacqui Palmer, Paediatric Dietitian for My Nutrition Clinic