Gluten and Coeliac Disease
Updated: Nov 25, 2020
Gluten is a protein that is found in wheat, rye and barley. I am commonly seeing more and more people undertaking a gluten-free diet. Many people find that a gluten-free diet makes them feel better from a digest perspective.
This makes sense as gluten activates zonulin, a protein that increases the permeability of the intestinal lining. An increase in the permeability (AKA leaky gut) of the digestive tract causes larger food particles to enter the bloodstream and spiking the immune system.
We know gluten activates zonulin, but it activates differently for different individuals. What we do know is that it does increase intestinal permeability in those with Coeliac Disease and possibly in those with IBS (irritable bowel syndrome).
But does this mean we should all avoid gluten?
Short answer no. If you can eat gluten with no digestive symptoms or worsening of other symptoms, then you can eat gluten rich food in moderation.
If you do suffer from digestive symptoms or have other symptoms that appear to worsen with gluten intake, then looking at getting tested for Coeliac Disease and regardless of the result, look at limiting or removing gluten products from your diet.
Why get tested for Coeliac Disease if you can just remove gluten from the diet?
Some people can have an immune reaction to gluten, otherwise known as Coeliac disease, causing the immune system to react abnormally causing irreparable damage to the small intestine and causes the villi (tiny, finger-like projections which line the intestine) to become inflamed and flatten which impairs the absorption of other nutrients through the digestive tract. Continual consumption of gluten for those with Coeliac disease causes continual damage to the intestinal lining and increases the risk of intestinal cancers.
Being tested for Coeliac disease is incredibly important and needs to be ruled out if you find that you are suffering symptoms linked to the consumption of gluten. This is because small traces of gluten can be harmful to the digestive tract for Coeliacs so by knowing if you have a positive or negative Coeliac test result allows you to take this into consideration.
Coeliac Disease Testing
Testing is completed in 3 stages, and all 3 stages must be complete to have a diagnosis of Coeliac Disease.
If you are ruled out, at stage 1 or 2, then you do not have a diagnosis of Coeliac disease and therefore consuming gluten is not permanently harmful to your digestive tract. If you continue to have symptoms, you may have Non-Coeliac Gluten Sensitivity which we discuss further below.
Stage 1 is genetic testing to rule out if you have the gene which predisposes you to Coeliac disease. Approximately 40% of the Australian population has the gene which predisposes you, however not everyone with the gene has Coeliac disease. The genetic testing is testing for HLA DQ2 and HLA DQ8, or parts of these genes. If these genes are not present, then immediately you can rule out Coeliac Disease.
Stage 2 is testing for gluten antibodies in the blood through a blood test. It measures antibody levels in the blood which are typically elevated in people with untreated coeliac disease, due to the body’s reaction to gluten. The difficulty with this step is that you have to be eating gluten products for a minimum of 4 weeks and in high doses before doing the challenge.
If Stage 2 is positive, then Stage 3 needs to be completed.
Stage 3 is a biopsy of the jejunal of the small intestine looking for damage to the small intestine.
If a diagnosis of Coeliac Disease is made, complete elimination of gluten is imperative to support your intestinal health and to prevent any further complications.
If you do have a positive result, working with a naturopath to ensure nutrient absorption is optimal, to prevent any further symptoms and avoid concomitant conditions such as autoimmune disease from becoming prevalent.
Non-Coeliac Gluten Sensitivity
Some people still have symptoms related to gluten regardless of their negative Coeliac Disease testing. Gluten is blamed as a trigger of symptoms by 20-45% of adults with self-report food hypersensitivity.
Non-coeliac gluten sensitivity (NCGS) is a condition where intestinal and extra-intestinal symptoms are triggered by gluten ingestion in the absence of coeliac disease and wheat allergy.
The symptoms are a combination of IBS-like symptoms, behaviour disturbances and overall body manifestations such as tiredness, headaches, fibromyalgia like joint or muscle pain, dermatitis or skin rash, depression and anxiety.
What can be done?
As a naturopath, I believe there is a lot of support that can be offered with either Coeliac disease or NCGS.
Optimising gut healing and digestive support are two key areas that need to be improved and with the assistance of herbs and nutrients this can be achieved.
Trust your gut feeling. Get in contact and start your journey to optimal health today.