Gluten intolerance (gluten sensitivity or gluten-induced enteropathy)
Coeliac disease is a common disorder in which chronic inflammation of the small intestine occurs because of a hypersensitivity towards the components of gluten found in many cereals. Inflammation results in the following symptoms such as weight loss, diarrhoea, nausea, anorexia, fatigue, depression and failure to thrive during childhood. The villi of the small intestine contain many enzymes which aid in breaking down food. Due to inflammation, the intestinal villi become narrow (villous atrophy) and disrupted, which primarily leads to disturbances in digestion and the uptake of nutrients (vitamins and minerals). Nutrient deficiencies can arise. Non-treated coeliac disease increases the risk of non-Hodgkin's lymphoma (lymph node cancer) and probably also cancers of the digestive tract, especially small bowel lymphoma. Coeliac disease is associated with type 1 diabetes mellitus in 5 to 10 percent of patients. Also, thyroid disorders occur frequently in coeliac patients. In adults, a vesicular rash with severe itching (dermatitis herpetiformis or Duhring’s disease) can occur and is a specific manifestation of coeliac disease.
The diagnosis is usually involves a blood test (measurement of transglutaminase as well as others) and a gastroscopy to sample tissue from the small intestine.
The treatment of celiac disease involves the exclusive adoption of a lifelong gluten-free diet. With this type of diet, the intestinal mucosa recovers and also reduces the risk of long-term health consequences. At the same time, it is important to follow a nutrient-rich diet to compensate for the deficiencies that occur from the injury caused by gluten on the small intestine. Strictly avoid all grains with high gluten content (i.e. wheat, barley, rye as well as their botanically-related prehistoric sorts including dinkel wheat [spelt], green (unripe) spelt grain, Khorasan or oriental wheat, Einkorn wheat, Emmer or hulled wheat, and the rye-wheat-crossed hybrid). Up to now, avoiding oats (a grass species) is also recommended. Millet, corn, rice, paddy rice ("wild rice"), amaranth, tapioca, buckwheat, quinoa, soy, teff or dwarf millet, chestnut, cooking bananas or plantain can be eaten. Some of these species are, for example, also used for the preparation of gluten-free beer. Vegetables and potatoes, salads, fruits, meat and fish, eggs, milk and dairy products can be eaten in all cases. Lactose intolerance usually disappears again when the villi are regenerated under the gluten-free diet.
We recommend undergoing this drastic change in diet together with experienced nutritional advice, which we can organize for you. In cases of severe deficiency of iron, vitamins, etc., we are able to provide supplementation treatment in our practice. Furthermore, we will clarify whether additional diseases such as diabetes mellitus, thyroid disease and others are present.
For more information, make an appointment with us. Detailed information is also available at www.zoeliakie.ch.