7 months ago

Allergy, intolerance and coeliac disease, and how to manage them.  

Intolerances, hypersensitivities, gluten allergy and coeliac disease can be hard to manage, and it can be difficult to navigate these conditions.  

Coeliac disease : 

Coeliac disease, also known as celiac disease, is a chronic autoimmune disease characterised by an intestinal pathology, which is triggered by the ingestion of gluten. It causes numerous issues such as damage to the inner lining of the intestine (known as Villous atrophy of the intestinal mucosa). 

This condition is more commonly identified in children than in adults, however it is not uncommon to diagnose in adult patients who suffer from stomach pains and chronic fatigue that can go unnoticed for years during biological testing. The disease is usually diagnosed 10 years after the 1st symptoms appear. 

In the event where coeliac disease is suspected, doctors will take a blood test in order to measure the level of antibodies responsible for the pathology : Immunoglobulin A (IgA) anti-transglutaminase. After a positive blood test, the patient will be referred to a gastroenterologist. The latter will perform a biopsy, which will allow for the confirmation of the diagnosis, but this step is not necessary in children.  

Food allergies : 

Food allergies (more specifically wheat allergies for our context) are characterised by relatively immediate symptoms (oedema, asthma…) but do not damage the lining of the gut in the way that coeliac disease or gluten intolerance/hypersensitivity might.

Gluten intolerance :

Intolerance in this case has the same symptoms as coeliac disease. It can appear gradually, and therefore remains difficult to detect as to the present day, there is no clinical way to diagnose it. 

Where is gluten found?

Gluten is often associated with wheat for the average person. In reality, gluten is the protein found in most cereals, and is present in wheat, spelt, barley, oats, rye and the lesser known triticale (SABOT). And yes, there is gluten in beer! Gluten is used for its elastic properties, which gives dough its airy and soft texture (visco-elastic properties). 

The cause of this disease still remains somewhat unclear, but research suggests that it may be influenced by the following:

  • Genetic predisposition : 95% of people with gluten intolerance carry one or more specific genes (HLA DQ2 = 95% of cases DQ8 = 5% of cases)
  • A trigger for the development of the immune process of the disease:
    • Introduction of gluten at too early of an age (> 3 months)
    • A high consumption of gluten
    • Lack of breastfeeding
    • Intestinal infections
    • The increase of modern hybrid wheat which is richer in gluten
    • Environmental toxins

What are the symptoms ? 

People with gluten sensitivity or coeliac disease report the following symptoms: 

  • Significant digestive problems (chronic diarrhoea, bloating, abdominal pain).
  • Chronic fatigue (muscular, psychological), apathy.
  • Are often subject to numerous deficiencies, anaemia…
  • Migraines.
  • Skin problems (acne, eczema…).
  • Weight loss or gain.

Unfortunately, there is no miracle treatment to date. The only preventive measures that can be taken is to avoid all foods containing gluten, regardless of the degree of the disease. 

The help of a dietician can be considered in order to allow the patient to appropriate their new diet. The purpose of a gluten-free diet should not be limited to giving lists of permitted and prohibited foods. It is essential to ensure that the patient’s nutritional needs are met and to combine pleasure and health by finding alternatives to gluten consumption.

Financial support is available for those with the condition, and can be allocated by a referral association, which can provide financial assistance through social security funds for gluten-free dietary products (AFDIAG). 

What can be consumed ? 

A gluten free certification label exists to help people identify gluten free products/brands : the logo with the crossed out ear of wheat (gluten free label). 

Beware of hidden gluten !

People with coeliac disease must pay great attention to cross contamination. For example, avoid using cutlery that was previously used with products containing gluten (toasters, knives etc.). The same applies to pre-packaged foods (ham), canned foods, food additives, colourings, etc.  In general, all industrial dishes should be checked. 

In addition, some medicines may also contain gluten (coating): spasfon, doliprane dry tablets…

As far as restaurants are concerned, you should not be afraid to ask for the allergen card. Many restaurants do provide a variety of gluten-free dishes, otherwise… Just ask the waiter nicely to remove the food containing gluten!

It’s all about organisation and reflexes. At the beginning of your gluten free journey, the hunt for labels, complicated aperitifs will seem tedious, but after a while it will become a habit.

The Nutrimis team.