Gluten and Coeliac Disease
Gluten free diets are increasing in popularity, especially in fitness circles but what is the rationale for eliminating this entire food group from your diet?
Gluten is a protein made up from the Gliadin and Glutenins. Gluten is contained mainly in certain grains including wheat, spelt, barley and rye.
Coeliac disease is an autoimmune condition which can lead to a variety of symptoms from digestive discomfort to mental health issues to an increased risk of certain types of cancer (1).
It is currently recognised that about 1% of the population suffer with coeliac disease although this number is increasing as methods of diagnosis improve and most cases go undiagnosed (1). The only treatment for coeliac disease is to permanently eliminate gluten from the diet which can often prove difficult, especially if eating a high proportion of pre-packaged foods (1,2).
If you have legitimate reason to believe you may be at risk you can ask your GP to be screened. The screening process is two staged and requires blood biopsies to be taken.
Because coeliac disease is often linked with Gastro Intestinal (GI) disorders it has become quite common for people to self-diagnose themselves with a condition that is now known as Non-Coeliac-Gluten-Sensitivity or NCGS (1,2).
NCGS isn’t a medical condition so much as a collection of symptoms. People with self-diagnosed NCGS often claim to experience GI distress, mental ‘fog’ and joint or muscle pain (2).
Another common digestive complaint is known as Irritable Bowel Syndrome (IBS). This, again is a combination of symptoms that are largely related to the consumption of certain fermentable fibres known as FODMAPS (1,2).
Scientists are still doing a lot of investigation into these areas but one thing which appears to be becoming clearer is that NCGS is possibly a sub-category of IBS (2).
People who claimed to have NCGS reported an improvement in symptoms when placed on a low FODMAP diet in accordance with IBS protocols (1,2).
There is also a strong cognitive link to IBS symptoms and it has been seen that people with a tendency towards stressful thinking and high stress lifestyles appear to experience an increase in symptoms (3).
- Coeliac disease is a severe autoimmune disease that requires medical diagnosis. The diagnosis of coeliac disease could potentially be a life saver. The only treatment for coeliac disease is the lifelong avoidance of gluten containing foods.
- NCGS may actually be less related to gluten intake and more to do with fermentable fibres called FODMAPS. Following a low FODMAP diet is often beneficial for people with both NCGS and IBS.
Chronic stress contributes to many illnesses and has a direct relationship with the function of the gut. So, you might literally be worrying yourself sick.
1. Lebwohl et al. “Celiac disease and non-celiac gluten sensitivity” BMJ 2015;351:h4347 doi: 10.1136/bmj.h4347
2. Jessica R Biesiekierski and Julie Iven (2015). Non-coeliac gluten sensitivity: piecing the puzzle together. sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/2050640615578388 ueg.sagepub.com
3. El-Salhy M. Recent developments in the pathophysiology of irritable bowel syndrome. World J Gastroenterol 2015; 21(25): 7621-7636 Available from: URL: http://www.wjgnet. com/1007-9327/full/v21/i25/7621.htm DOI: http://dx.doi. org/10.3748/wjg.v21.i25.7621