There was a time when gluten sensitivity was not taken as seriously as it needed to be, particularly for those diagnosed with coeliac disease. The incidence of coeliac disease has risen dramatically in New Zealand and there is now an unprecedented level of awareness of it and the importance of a strict gluten-free diet for the wellbeing of people with this condition.
If you have coeliac disease and you eat gluten, the lining of your small intestine is damaged and your body will have difficulty absorbing nutrients. There can also be more generalised symptoms.
Coeliac disease can be confirmed with blood tests and the biopsy appearance of your small intestine, and although gluten sensitivity is more common, it is less easy to define and often confusing.
Most people tolerate gluten in their diets with no problem, but if you discover you have gluten sensitivity, going gluten-free may be the answer to your health problems.
The diagnosis of any food intolerance can be a mixed blessing. On the one hand, there is a sadness and frustration that foods which other people can happily enjoy are out of your life forever.
The trade-off is that it may provide the answer you have long sought to explain your symptoms and have you feeling well and full of energy again.
What is gluten?
Gluten is a protein found in the grains wheat, oats, rye, spelt, barley and triticale. It can also be found in many processed foods.
Signs of Coeliac Disease
According to Coeliac New Zealand, 65,000 Kiwis have the auto-immune disorder, but most of those don’t have a diagnosis.
These could be the clues to a diagnosis of coeliac disease:
Diarrhoea or constipation
Anaemia
Mouth ulcers, a sore tongue and sore mouth
Weight loss
Infertility
Unexplained weakness, fatigue, anxiety, depression
Deficiencies in iron, B12 or folate
Indigestion, abdominal pain, bloating
Bone pain (osteoporosis)
If coeliac disease is suspected, it needs to be formally diagnosed.
Could it be gluten sensitivity?
Once coeliac disease has been ruled out by medical testing, and your symptoms have been investigated for other medical causes, if your symptoms seem to be related to gluten exposure, you could have gluten sensitivity or a related food intolerance.
Gluten sensitivity can take many forms. It is a condition that can affect your whole body, every organ, have an effect on your moods and personality, and an impact on work, friendships and family relationships. Some of the most commonly affected areas include:
Gut
There may be the characteristic gut symptoms such as Irritable Bowel Syndrome, abdominal bloating, abdominal pain, diarrhoea or constipation, and indigestion.
Brain
People with gluten sensitivity may describe various brain and nervous system-related symptoms, including clumsiness, headaches, irritability and brain fog, and a blunting of the ability to think and concentrate when exposed to gluten. This can take several days to clear completely after an exposure. Mood changes can be mistaken for depression.
Fatigue
Fatigue can be related to the multiple nutritional (iron, B12, folate) deficiencies, muscle weakness or neurological complications of gluten sensitivity.
Skin
A skin rash that is associated with exposure to gluten can disappear once a gluten-free diet has been in place for some time.
Joints
If you have gluten sensitivity, you may experience joint pain hours or even days after gluten exposure.
Gluten sensitivity can affect your mood.
Places where you may find gluten:
Licking stamps or envelopes.
Some medications, vitamins and other supplements.
Food preparation techniques in restaurants such as tossing grilled fish in flour; lining soufflé dishes with flour.
Pre-packaged stock.
Soy sauce.
Pre-packaged basting sauces.
‘Cornflour’ that is actually made from wheaten cornflour.
French fries and hash browns may contain or be tossed in flour for storage.
Some salad dressings.
Some pre-packaged soups and sauces.
Some tea bags.
Communion wafers.
To assess whether gluten is a problem for you, you will first need to be tested for coeliac disease while you are still consuming gluten. Obviously, if you have coeliac disease, you will know to keep a strict gluten-free diet for life and correct any nutritional deficiencies.
If you do not have coeliac disease, but your symptoms seem to be gluten-related, you will be advised to trial a gluten-free diet over several months to see whether your symptoms improve. If you then rechallenge yourself with gluten-containing foods and your symptoms return, you will know. There may be other associated food intolerances. I suggest you seek advice from your doctor and a qualified dietitian.
Go to coeliac.org.nz for more information.
Words by: Professor Kerryn Phelps
Photos: Getty Images
