Is coeliac disease a food allergy?

No. It's an autoimmune disease. The immune system responds to gliadin, the protein portion of gluten, by damaging the lining of the small intestine. An allergy is a different mechanism.

Should I go gluten free to see if it helps?

Not before you're tested. Going gluten free first can produce a false negative, because testing looks for the immune response to gluten you're no longer eating. Speak to your GP about testing before you change your diet.

How long do I need to stay gluten free?

For life, once you're diagnosed. Damage to the small intestine begins again when gluten is reintroduced, whether or not you notice symptoms.

Coeliac Disease | Naturopath Melbourne, Brunswick West

Coeliac disease is an autoimmune condition that damages the small intestine when gluten is eaten.

The protein portion of gluten, called gliadin, damages the villi — the small finger-like projections lining the small intestine that absorb nutrients. When gluten is consumed the villi flatten, and over time that leads to malabsorption. Left undiagnosed or untreated it can cause serious gastrointestinal problems.

Symptoms

Unexplained weight loss, fatigue and lethargy, bloating, constipation or diarrhoea, skin rashes, iron deficiency anaemia, recurrent mouth ulcers and a swollen tongue. In children it can show up as failure to thrive, delayed growth or delayed puberty.

Every one of those symptoms has other possible explanations. Get properly assessed before you decide you have coeliac disease — and get tested before you remove gluten, because removing it first can make the test unreliable.

What gluten is

Gluten is found in wheat, oats, barley, spelt and rye. Gliadin, its protein portion, is the part responsible for the damage.

How it’s treated

With a strict gluten-free diet, permanently. There are far more alternatives in supermarkets and health food shops than there used to be, and exploring different grains is a reasonable place to start.

Where a naturopath fits

A gluten-free diet stops the damage. It doesn’t automatically undo what malabsorption has already cost you.

Your naturopath can assess your nutritional status, arrange pathology where it’s clinically appropriate, and support the repair of the gut lining with nutritional and herbal medicine. They can also help you make a gluten-free diet genuinely nutritious rather than simply gluten-free, which is a different thing.

Coeliac Australia publishes a pocket guide to dietary recommendations and label reading that’s worth having.

Coeliac disease