Coeliac disease is a permanent disease of the small intestines, caused by an allergic toxicity to the gliadin protein found in gluten cereals. Where the condition is present, the lining of the small intestines is unmercifully attacked by gliadin (it doesn’t take much gliadin – less than half a gram a day can cause this reaction). The lining becomes damaged and loses its ability to absorb nutrients from food. Malabsorption and malnutrition therefore follow, inducing deficiencies in iron, zinc, calcium, magnesium, potassium and vitamins B6, B12, folic acid A, D, E and K.
There is a strong genetic aspect to coeliac disease. In identical twins, for example, of those who suffer, in 70% of cases both twins have it, making it 175 times more prevalent among twins than the general population. If you have a mother, father, brother or sister with coeliacs, you have a one in ten chance of having it too, which means you have a 30 times higher risk than the average person.
Medical textbooks still say, wrongly, that it occurs in only one in five thousand or so people. Due to remarkable advancements in laboratory screening for coeliacs, we have learnt that it occurs more frequently than ever imagined. According to a random sampling by the Red Cross, 1 in 250 Americans suffer from coeliac disease (19 out of every 20 of whom go undetected and untreated). More recent studies appearing in the Lancet medical journal have reported a prevalence of 1 in 122 in the Irish, 1 in 85 in the Finnish, 1 in 70 of the Italians in Northern Sardinia, and 1 in 18 in Algerian Saharawi refugee children.
Coeliac disease is thought to be such a health threat in Italy that the government has considered mandating that all children, regardless if they are sick or not, must be tested for gliadin sensitivity and coeliac disease by age six. In Britain, we are still in the Dark Ages in terms of recognising the widespread prevalence of coeliacs.
Screening and diagnosing coeliac disease
Coeliacs used to be diagnosed only by means of a gut biopsy showing atrophy (ie damage) of intestinal villi (the cells which line the intestine). Many doctors regard this biopsy as the ‘gold standard’ for the diagnosis of coeliac disease. It is commonly an outpatient procedure performed by a specialist, where a long tube is inserted through the mouth, oesophagus, stomach and finally into the small intestine, where several samples of mucosal lining are taken. A pathologist, looking for the characteristic mucosal lesions of coeliac disease, then studies these small pieces of tissue under a microscope.
While a gut biopsy is certainly thorough, it is also expensive and inconvenient. Many doctors and their patients are understandably reluctant to have it performed unless there is very good reason for doing so. So this is where modern laboratory science comes into play.
Less invasive screening techniques for coeliacs
New non-digestive symptoms linked to coeliacs
The osteoporosis connection
Increasing risk of cancer
Can coeliac sufferers eat oats?
The only known cure
Healing the digestive tract
Glutamine – your gut’s best friend
Beneficial bacteria – getting the balance right
30 day action plan for coeliac recovery
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