A strict gluten-free diet is currently the only treatment for coeliac disease.
The only treatment for coeliac disease is lifelong avoidance of all foods containing gluten. Even trace amounts of gluten can cause damage to small intestinal mucosa. Therefore patients with a new diagnosis of coeliac disease should be referred to an expert dietitian to avoid nutritional deficiencies [1].
Gluten is found in wheat, rye, barley and contaminated oats, and products that contain these ingredients. In addition to obvious sources of gluten, such as breads, pasta, biscuits and pastries, smaller quantities are also present in less obvious food products including processed meats, soups, sauces and confectionary. Particular caution is therefore recommended when shopping and eating away from home.
Gluten-free products
A large number of specialist gluten free products are available on prescription and in supermarkets to support people with coeliac disease to follow a gluten free diet. Prescription products are often tailored to meet the nutritional needs of coeliac patients, being fortified with additional micronutrients including calcium and folic acid.
Click here to learn more about Glutafin Gluten Free prescription products.
Benefits of a gluten-free diet
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Normalisation of antibody values
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Regeneration of small intestinal mucosa
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Reduced risk of medical complications/long term consequences
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Improved nutrient absorption
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Improvement in general health and wellbeing
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Improvement in quality of life
Conditions associated with undiagnosed/untreated coeliac disease
Failure to accurately diagnose coeliac disease or to follow a strict gluten free regime following diagnosis may result in a number of serious long term health consequences:
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Iron-deficiency anaemia
Anaemia and other micronutrient deficiencies are common in newly diagnosed coeliac disease owing to malabsorption, secondary to small bowel villous atrophy. Adherence to a strict gluten free diet will correct levels if oral intake is sufficient. -
Osteoporosis
Undiagnosed/untreated coeliac disease is associated with low bone mineral density, osteoporosis and increased risk of fractures. Approximately 75% of adults with untreated coeliac disease suffer from osteopenia or osteoporosis. A strict gluten free diet has been shown to improve bone mineral density [1]. The British Society of Gastroenterology (BSG) recommend measurement of bone mineral density after 1 year of a gluten free diet in patients above the age of 55 years or in those with other risk factors for osteoporosis [2] -
Lymphoma
Coeliac disease is associated with a modestly increased risk of small bowel lymphoma, namely non-Hodgkin’s lymphoma, compared to the general population [2]. However, overall risk remains low and is likely to be reduced to the same level as the general population following 3-5 years on a gluten free diet [3,4].
References
- Corazza GR, Di Stefano M, Maurino E. Bones in coeliac disease: diagnosis and treatment. Gastroenterology 2005 19(3): 453-46
- Ludvigsson JF, Bai JC, Biagi F, et al. Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology. Gut 2014; 63: 1210–28
- West J, Logan RFA, Smith CJ et al. Malignancy and mortality in people with coeliac disease: population based cohort study. BMJ 2004 329:716-718
- Holmes GKT, Prior P, Lane MR et al. Malignancy in coeliac disease, effect of a gluten free diet. Gut 1989. 30: 333-338.
- Askling J, Linet M, Gridley G. Cancer incidence in a population-based cohort of individuals hospitalised with coeliac disease or dermatitis herpetiformis. Gastroenterology 2002. 123(5):142-135
