If your child, or someone you know, has recently been diagnosed with gluten intolerance, or coeliac disease, then the reality of living a gluten-free lifestyle will be starting to dawn. To make the many changes ahead, it helps to understand the condition: what causes it; its symptoms; and how best to treat it. Then you can help your child, your family members, friends and others to understand the importance of a gluten-free diet, making your child’s life happier and healthier.
Below I have summarised some of the questions and answers that you may face:
What is gluten?
- Gluten is a protein found in cereal grains such as wheat, barley, rye and to some extent in oats.
- Gluten is present in many commercial products such as breads, cakes, soups, sauces, crisps, processed meats (such as sausages), gravy, seasonings, soya sauce, sweets, drinks and most ready-made meals.
How do I know if my child is intolerant to gluten?
- Symptoms for gluten intolerance (see box) can vary widely and can be difficult to pinpoint. If you suspect your child is gluten intolerant you must discuss this with your doctor or GP.
- Your doctor or GP can arrange a blood test. This test is used to detect specific antibodies present in people with coeliac disease. People with coeliac disease are unable to eat gluten.
- If the blood test proves positive, your GP will refer you to a specialist, usually a gastroenterologist. The gastroenterologist will perform a gut biopsy or endoscopy. This is done in hospital and will confirm his/her diagnosis.
- Please note that allergy testing kits are not suitable for testing gluten intolerance nor should you make any attempt to self- diagnose your child. It is imperative that you seek medical advice before making any changes to your child’s diet.
- It is also worth noting that being allergic to wheat or gluten is different from being gluten intolerant.
What is coeliac disease?
- Coeliac disease is an autoimmune disease which affects the body’s digestive system.
- If you are a coeliac and you consume gluten, your body reacts by sending antibodies to attack the gluten protein in the lining of the small bowel causing inflammation and damaging the villi. This is known as an autoimmune disease, because essentially the body is attacking itself.
- Villi are fine hair-like structures in your digestive tract, which slow down the passage of food in the intestine and aid digestion. This process allows nutrients in food to be absorbed. When the villi are damaged, food ingested flows straight through the digestive tract without being digested. This means that most of the nutrients in the food you consume are not absorbed by the body.
- Because the symptoms often mirror other conditions, like irritable bowel syndrome or some stress-related illnesses, coeliac disease can be difficult to diagnose.
Why has my child developed coeliac disease?
Coeliac disease can be inherited and is known to run in families. If you have coeliac disease there is also an increased risk of having other autoimmune diseases, including Type 1 diabetes.
What is the treatment?
- Long term, if left untreated, coeliac disease can lead to malnutrition, osteoporosis (weak and brittle bones) and, particularly worrying in children, stunted growth and development.
- There is no known cure for coeliac disease. The only way to treat the disease is to completely exclude gluten from the diet. In the majority of cases this is a lifelong situation.
- When you are first diagnosed you will be referred to a nutritionist who will advise you on what foods to avoid and how to change your diet. It is important to continue to exclude these foods, as consumption of gluten, however small, will trigger symptoms.
When will my child start to feel better?
You should notice an improvement within a few weeks of starting a gluten-free diet. The body will repair itself over time and you will soon see the benefits of improved nutrition.
What does ‘gluten-free’ mean?
Gluten-free means excluding gluten from your diet completely. Ensuring your child follows a gluten-free diet can be very difficult. For many, this is not something they will grow out of – it’s a lifelong condition that requires a complete change in diet. But more than just a diet, being gluten-free can have many social and psychological implications. In the following section, ‘Adapting to a Gluten-free Lifestyle’, I have made suggestions for dealing with different situations and helping your child to live a normal life.
The great news is that a gluten-free diet doesn’t need to be dull or boring, and more and more people are choosing a gluten-free lifestyle simply for the health benefits. Less reliance on processed food and more emphasis on fresh, natural food will in itself make for a healthier diet. The recipes in this book are a great start!
How many people are affected by this condition?
- Coeliac UK, the registered charity, estimates that 1 in 100 people in the UK are affected by coeliac disease.
- Over 10,000 new cases are diagnosed in the UK each year.
- Coeliac UK estimates that 1 in 8 people have been diagnosed.
- Coeliac UK estimates that 500,000 people in the UK are living with the disease undiagnosed.
“Wheat-free” does not mean “gluten-free”. Wheat-free products may contain barley, oats or rye, all of which contain gluten.
In the USA it is estimated that up to 3 million people are affected by gluten intolerance. 1 in 133 people in the US will have coeliac disease, although only 1 in 4,700 will be diagnosed.
In Australia, 1 in 100 people have coeliac disease. More than 80 per cent (or the equivalent of 200,000 people) are living with this disease undiagnosed.
For further information on coeliac disease and organisations please see the section entitled Useful links