Coeliac Disease

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Coeliac disease, Celiac disease, Non tropical sprue, Gluten enteropathy.

Description: This is a quite common usually inherited disease affecting almost 1 in 130 people.  Some people believe we all have partial gluten intolerance, some are affected more than others.  It is caused by an allergic reaction to Gliadin (which is part of the Gluten protein) found in wheat, barley and rye. The immune system creates antibodies against the gliadin but also attacks the lining of the small intestine. The fine villi (tiny finger like projections into the small bowel) are damaged by this process and this hugely reduces food and nutrient absorption. This causes diarrhoea, bloating,abdominal pain, often an intolerance to milk (lactose), and greatly reduces the nutrients absorbed from the food leading to nutritional deficiency (anaemia, osteoporosis, selenium, copper and zinc deficiency and can also affect bleeding (vitamin K).  It also may allow larger molecules to enter the blood stream (leaky gut); this is believed to be the cause of many immune diseases or symptoms. The disease is inherited, and there is a blood test for the gene HLA-DQ2 or HLA-DQ8 alleles - but not everyone with these genes develops Coeliac and some people without them can also have the disease. There is also a very wide spread from very mild and asymptomatic disease right through to severe symptoms.

What doctors can do

Previously the diagnosis has been difficult, but there are now blood tests, immunoglobulin A (IgA), anti-tissue transglutaminase (tTGA), and IgA anti-endomysium antibodies (AEA). Note that these tests must be done while eating a diet that contains gluten. The levels will fall when the patient is eating a gluten free diet. Genetic screening (for the Alleles) is probably unnecessary.

The doctor will usually recommend a gluten-free diet - avoid foods containing wheat, barley and rye. Surprisingly although it is known Celiac disease causes poor absorption, few doctors recommend nutritional supplements!

What you can do

Lifestyle

  • Even a tiny amount of gluten can cause the reaction, so it is best to be meticulous in taking no gluten – this means a person with coeliac disease should not eat most grain, pasta, cereal, and many processed foods. Check the label for gluten because many additives and fillers contain gluten. It is exciting to see the gluten free foods now becoming available making the diet of celiac patients much less boring.
  • It is helpful to note foods that are safe - soybean, tapioca flour, rice, corn, buckwheat and potatoes.
  • Dairy foods may cause problem - not because of the gluten, but patients can often be lactose intolerant as well.
  • There is some debate about oats. It is best to eliminate those initially and then when stable, try and see if oats also cause the problem.
  • A gluten-free diet is not easy to adhere to, but the benefits for people with this disease are huge, because untreated, the condition can lead to some very serious illnesses, including cancer. Fortunately, more and more gluten-free foods are becoming available. It is important to check the labels on food, as many fillers and additives can contain gluten.
  • Remember, this is an inherited disease, so check other family members.
  • A new approach to the disease is appearing - the use of enzymes which dismantle the gluten before it reaches the small bowel.  It is still safer to eat gluten free is possible, but when one is uncertain about a meal in a restaurant, this product may be very useful.

Nutritional supplements

  • In coeliac disease, where poor absorption of food is the major pathology and causes symptoms and complications, the value of taking supplements seems so obvious that it is hard to understand why the medical profession ignores it.
  • A good multivitamin/multimineral makes sure that the body has a surfeit of all the nutrients and minerals required to function, grow and develop perfectly.
  • Omega 3 fish oils, 1–2 grams daily. These are very important for tissue, joint and brain health.
  • Calcium and magnesium, 800-1,000mg/day. Magnesium has a very calming effect, helps with sleep, and relieves the cramps which many coeliac patients suffer.
  • Vitamin D affects many allergic and inflammatory illnesses, it would be worthwhile taking this, 5,000iu at least daily. (Vitamin D seems to have many beneficial actions, including turning the genes on and off when required. Low D levels are present in many diseases and it does seem important to have adequate levels all year round)
  • Probiotics - because of poor absorption higher in the bowel, many sugars and undigested foods reach the colon and cause much of the bloating and diarrhoea. It can also change the bacteria colonising the gut. Regular use of a probiotic containing the good bacteria seems a wise option.
  • Selenium. In countries where there are low levels of selenium in the soil, selenium supplements are very important in reducing the risk of developing a number of diseases.

The Nutritional supplements I use and recommend to my patients

For Coeliac patients - USANA - Cellsentials * , Biomega, Active Calcium plus, , Proflavanol C, probiotics and vitamin D -

Other therapies

There are a number of other therapies which you might like to look at.  They have not been specifically included with this disease because some are a form of treatment which is applicable to most diseases and many focus on the mind, body, spirit, and the universe. These include - acupuncture, Ayurvedic medicine, energy healing, homeopathy, naturopathy, prayer, visualisation and some people with this condition might like to look at these topics (I have described them more fully on another page on this website click here .) With my personal experience and reading, I do not think that I can comment of whether one or a number of these might help.    They fit well with most conventional and complementary treatments and I suspect some or even all of them can be extremely powerful - if performed by an experienced practitioner.    My only caveat is that if in the course of one of these therapies, you are given potions or herbs, do check with your health practitioner that they will not interfere with other treatments or drugs you are receiving.

Nutritional supplements

I believe in today's world that nutritional supplements are so necessary as to be an essential component of any form of both prevention and treatment. Not only is today's food lacking in nutrients because of the way it was grown and processed, but also most of us make the wrong choices in diet. It is virtually impossible to obtain optimal levels of most of the vitamins, minerals and other nutrients although many people try to do so, and even then fresh produce is not available all year round. *There are many quality supplements available on the market, including –Thorne, NFS, Douglas Labs, Xtend Life, True Star Health, USANA, and Metagenics. There are others, but do your due diligence before choosing one. USANA Health Sciences has added a new adjunct to its multivitamin and multi mineral called CellSentials. These are a patented blend of phyto-nutrients which they believe affects cell signaling and growth, and increases the production of preventative antioxidants within the cell. These should add to the value of the multi, so these are the multivitamin/mineral preparation I recommend.