Coeliac Diets

Definition of Coeliac Disease

Coeliac disease is an autoimmune disorder triggered by the ingestion of gluten, leading to damage in the small intestine. It is not a food allergy or intolerance; it is a serious medical condition where the immune system attacks its own tissues when gluten is eaten.

Gluten

Definition

Gluten is a protein found in wheat, barley, and rye. It gives elasticity to dough, helping it rise and maintain its shape, and often gives the final product a chewy texture.

Significance in Coeliac Disease

In coeliac disease, the immune system reacts abnormally to gluten, causing damage to the lining of the small intestine. This impairs nutrient absorption and can lead to various symptoms and complications.

Immediate Effects of Coeliac Disease

• Digestive Symptoms: These include bloating, diarrhoea, constipation, gas, and abdominal pain.
• Malabsorption: Due to intestinal damage, which can lead to deficiencies in vitamins and minerals.

Long-term Complications of Coeliac Disease

• Nutritional Deficiencies: Such as anaemia due to poor iron absorption.
• Bone Disorders: Like osteoporosis and osteomalacia, due to poor calcium and vitamin D absorption.

Dietary Requirements of Coeliac Disease

Gluten-Free Diet: The Only Effective Treatment

• Avoidance of Gluten: Eliminating all foods containing wheat, barley, and rye.
• Alternative Grains: Consuming gluten-free grains like rice, corn, quinoa, and buckwheat.
• Reading Labels: Being vigilant about food labelling to avoid gluten-containing ingredients and cross-contamination.
• Whole Foods: Emphasising naturally gluten-free foods, such as fruits, vegetables, meat, fish, dairy, nuts, and legumes.
• Gluten-Free Products: Utilising specifically manufactured gluten-free products, like bread and pasta.

Nutritional Considerations

• Balanced Diet: Ensuring a balanced intake of nutrients, as gluten-free diets can be low in fibre, iron, calcium, and B vitamins.
• Supplements: Considering supplements, under medical guidance, to address potential nutritional deficiencies.

Exam Focus: Questions and Answers

1. Define coeliac disease and explain the role of gluten in this condition.

Coeliac disease is an autoimmune disorder where the ingestion of gluten leads to damage in the small intestine. Gluten, a protein found in wheat, barley, and rye, triggers an abnormal immune response in individuals with coeliac disease, causing intestinal damage that impairs nutrient absorption and leads to various symptoms.

2. Discuss the immediate effects and long-term complications of coeliac disease.

The immediate effects of coeliac disease often include digestive symptoms like bloating, diarrhoea, and abdominal pain. Long-term complications can arise from continued gluten ingestion, including nutritional deficiencies like anaemia and bone disorders such as osteoporosis.

3. What are the dietary requirements for managing coeliac disease?

Managing coeliac disease requires a strict gluten-free diet, avoiding all foods containing wheat, barley, and rye. This includes choosing gluten-free grains and products, reading labels carefully to avoid cross-contamination, and maintaining a balanced diet. Supplements may be necessary to address nutritional deficiencies associated with the diet and the disease.