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Written by Barbara Collins
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A dietary disease of the intestines, coeliac disease affects
approximately one in fifteen hundred people in the United Kingdom. The
condition is caused by a sensitivity to the protein gluten, which is
found in cerals such as wheat, rye and barley. It occurs in adults and
children, and tends to run in families. I n children it may arise
within a few months of taking solids such as cereals or rusks that
contain gluten, but it can manifest itself at any age. Adults who
develop it may have a mild or symptomless form of the disease in
childhood.
In susceptible people, gluten damages the villi - minute hair-like
projections lining the small intestine - and this can inhibit the
absorption of nutrients. The first signs in children are usually
repeated stomach upsets and a failure to thrive. Other symptoms
normally include bloating, diarrhoea, anemia and weight loss. Adults
may also experience fatigue, depression, a general loss of well-being,
mouth ulcers, dermatitis or infertility.
A correct diagnosis can be made only by having a biopsy, when a sample
of the small intestine is removed and examined. The patient will then
be put on a strict gluten-free diet. The biopsy may then have to be
repeated in order to establish whether or not cutting out gluten has
allowed the lining of the gut to recover. If the intestinal villi have
recovered, the diagnosis is confirmed.
Once the disease has been identified, patients are advised never again
to eat anything that contains gluten. Some people may be advised by
their doctor to take extra vitamins and minerals for the first few
months until they are accustomed to planning a gluten-free diet that
provides all the nutrients they need. A marked improvement in health
should become apparent within just a few weeks.
Avoiding Gluten
Hundreds of everyday foods contain gluten: breads, cakes, biscuits and
pasta, sausages bound with breadcrumbs, foods covered with batter, as
well as sauces and soups thickened with wheat flour, all contain the
protein. Most breakfast cereals should also be avoided.
If your baby has developed coeliac disease you will need to check the
ingredients on baby foods, although most first-stage foods are
gluten-free.
Always read the labels of commercially prepared foods, and beware of
ingredients such as flour-based binders and fillers and modified
starch. Avoid drinks such as lemon barley water, and brewed drinks made
with barley such as beer and stout. Coounion wafers also contain gluten.
To replace any prohibited foods, eat plenty of potatoes, pulses, rice,
corn and nuts. Use cornflour, rice flour, soya flour or chestnut flour
to thicken sauces. Balance the diet with fresh vegetables and fruit,
eggs, milk and cheese, as well as meat, poulty and fish - hte fish can
be fresh or canned.
Avoiding gluten is difficult, so it is best to seek the advice of an
experienced dietitian who can help you to maintain a balanced, healthy
diet.
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