Coeliac disease is one of the more common autoimmune diseases. Mainly triggered by gluten consumption, it can make life difficult in many ways.
Either way, you can manage it by following the right diet. Sometimes it is worth using supplements, e.g. to avoid deficiencies. First and foremost, a proper diagnosis should be made.
Do I have coeliac disease? Diagnosing the problem
Diagnosis is a fundamental element that allows steps to be taken toward improving health. Unfortunately, coeliac disease is not so easy to diagnose unequivocally. We know that it is induced by gluten consumption, although a genetic factor also plays a role.
All the more so because we often try a gluten-free diet on our own, hearing everywhere how this specific protein affects the body. In such a case, despite the many diagnostic options, genetic testing is the only option. It is worth knowing that, according to statistics, more than 30% of European residents show an increased risk of developing the disease. This concerns a specific HLA-DQ2/DQ8 genotype associated with a higher risk of coeliac disease.
Who should get tested?
First and foremost, relatives (first-degree relatives) of those diagnosed with the disease. Of course, it is also worth getting tested if intestinal symptoms are observed. All the more so because, as we know, coeliac disease is an inflammatory disease of the small intestine with an immune basis. Nevertheless, extraintestinal symptoms may also occur. Another issue is that it can remain hidden for a long time (e.g. only as iron-deficiency anaemia).
In addition, it should be borne in mind that coeliac disease often occurs together with other problems, and these people are also in the risk group. These include people struggling with autoimmune diseases such as Duhring's syndrome or type 1 diabetes.
Other diagnostic tests, in order to obtain a correct result, should be performed while consuming gluten normally – 2-3 slices of regular bread a day for about two weeks are enough. These will be serological tests:
- tTG (level of antibodies against tissue transglutaminase),
- DPG (deamidated gliadin peptides),
- EmA (smooth muscle endomysium).
The tTG test is performed in the IgA or IgG antibody class. There are patients in whom IgA deficiency is noted with coeliac disease - in such cases, the second option (IgG) should be chosen.
Coeliac disease - how to deal with it?
The basic and necessary condition in diagnosed coeliac disease is the so-called gluten-free diet. As the name suggests, it involves excluding products containing gluten, i.e. a specific mixture of plant proteins that includes, among others, gliadins and glutenins. These are found mainly in cereals – wheat, barley, rye.
There is also increasing talk about contamination of oats with gluten during technological processing. Therefore, for safety, it is often recommended to eliminate it from the diet.
Gluten may also be present in non-cereal products. Its sources include, for example:
- emulsifiers,
- stabilizers,
- malt,
- maltose, maltodextrin and dextrin,
- modified starch.
Coeliac disease is a condition characterised by atrophy / damage to the intestinal villi, so in addition to eliminating gluten - the trigger and a factor that worsens symptoms – one must keep in mind digestive issues. Therefore, the diet should be based on gluten-free products and be easily digestible.
Much also depends on the degree of damage to the intestinal villi, individual tolerance and consumption of the ingredient itself. Nevertheless, in coeliac disease, complete elimination is recommended. We therefore rely on products that do not contain it by nature and on those marked with the crossed grain symbol. The latter are information for the consumer, letting us know that the manufacturer does not even allow contamination of its product with gluten.
Interestingly, you can even come across meat that contains the aforementioned mixture of plant proteins. This most often happens in supermarkets or shops where both meat and meat products are sold. For this purpose, spices containing trace amounts of them are used, which creates a risk of contamination.
As an interesting note, a large proportion of people dealing with coeliac disease may not tolerate eggs, which in such circumstances act in a pro-inflammatory way. It is advisable to perform tests aimed at food intolerances.
There is also something called the autoimmune protocol, which is implemented when the problem is diagnosed at a fairly advanced stage. Most often, to determine the extent of damage to our intestinal villi, gastroscopy with collection of several biopsy samples from the duodenum is used, to investigate coeliac disease.
The autoimmune protocol is particularly applicable when tests confirm coeliac disease and villous atrophy is at level 3 on the so-called Marsh scale (coeliac disease can already be suspected at the second level). It is used for microscopic assessment of the degree of villous atrophy. In that case, we absolutely avoid groats, legumes, and even nuts or seeds.
Of course, over time some gluten-free products are gradually reintroduced, although it is important that they are as minimally processed and as highly nutritious for the body as possible. If the aforementioned crossed grain symbol is visible on the packaging, the following are recommended:
digestive issues. Therefore, the diet should be based on gluten-free products and be easily digestible in itself.
Much also depends on the degree of damage to the intestinal villi, individual tolerance and consumption of the ingredient itself. Nevertheless, in coeliac disease, complete elimination is recommended. We therefore rely on products that do not contain it by nature and on those marked with the crossed grain symbol. The latter are information for the consumer, letting us know that the manufacturer does not even allow contamination of its product with gluten.
Interestingly, you can even come across meat that contains the aforementioned mixture of plant proteins. This most often happens in supermarkets or shops where both meat and meat products are sold. For this purpose, spices containing trace amounts of them are used, which creates a risk of contamination.
As an interesting note, a large proportion of people dealing with coeliac disease may not tolerate eggs, which in such circumstances act in a pro-inflammatory way. It is advisable to perform tests aimed at food intolerances.
There is also something called the autoimmune protocol, which is implemented when the problem is diagnosed at a fairly advanced stage. Most often, to determine the extent of damage to our intestinal villi, gastroscopy with collection of several biopsy samples from the duodenum is used, to investigate coeliac disease.
The autoimmune protocol is particularly applicable when tests confirm coeliac disease and villous atrophy is at level 3 on the so-called Marsh scale (coeliac disease can already be suspected at the second level). It is used for microscopic assessment of the degree of villous atrophy. In that case, we absolutely avoid groats, legumes, and even nuts or seeds.
Of course, over time some gluten-free products are gradually reintroduced, although it is important that they are as minimally processed and as highly nutritious for the body as possible. If the aforementioned crossed grain symbol is visible on the packaging, the following are recommended:
- buckwheat,
- quinoa,
- amaranth.
The above contain a complete set of essential amino acids, so they are a great addition to a complete and nutritious gluten-free diet.
