This piece was written in partnership between Dr Hazel Wallace and Specialist Gastroenterology Dietitian – Cristian Costas.
#1: Coeliac Disease is a gluten allergy or intolerance
Coeliac Disease not an allergy or an intolerance.
It is an autoimmune condition that causes the body to attack itself when gluten is eaten and this causes damage in the small intestine.
In an intolerance, like non-coeliac gluten/wheat sensitivity, symptoms may be similar to those experienced by people with Coeliac Disease, but it is not clear how the immune system might be involved and there does not appear to be damage to the lining of the gut.
In an allergy [wheat allergy for example] there is involvement of the immune system and symptoms can appear outside of the digestive system like in coeliac disease. But there is no gut damage.
#2: People with Coeliac Disease just have to avoid wheat
People with Coeliac Disease have to avoid all foods containing gluten.
Gluten is a protein that is found in wheat, but also in other grains like barley and rye.
Technically oats don’t have gluten but can be contaminated so always choose gluten free oats, but some people are still not able tolerate oats at all due to a similar protein called avenin.
#3: A little bit of gluten won’t do you any harm if you have Coeliac Disease
Unfortunately gluten causes gut damage for people with Coeliac Disease at the smallest level and a tolerance to it cannot be built.
Studies have shown that as much as 1/100th of a slice of bread is enough to cause gut damage for people with Coeliac Disease. Therefore foods that are gluten-free need to have much less than a crumb of gluten to be suitable to eat.
This is also why strict measures to avoid cross contamination [i.e. when gluten comes into contact with gluten-free food in the cooking process] is also super important for those with Coeliac Disease.
#4: Coeliac only affects people from European origin
Coeliac Disease affects people across the whole world.
In fact prevalence around the world is estimated to be similar to the UK – around 1 in 100 people. Some countries may have higher or lower prevalence rates but on average for most countries the data on it is 1%.
There is a genetic component, the risk is about 10% for those with a first degree relative with Coeliac Disease.
#5: You have to have digestive symptoms to have Coeliac Disease
You definitely do not. In fact many people present with the non-digestive symptoms of Coeliac Disease which can include:
- mouth ulcers
- skin rashes
- loss of sensation of fingers and toes
- unexplained weight loss
- vitamin and mineral deficiencies
- …amongst others
Not everybody gets all of the symptoms and the symptoms are not always severe. In fact, 20% of people with Coeliac Disease don’t have any symptoms.
#6: You only get diagnosed with Coeliac Disease as a child
Coeliac Disease can affect people at any point in their life, whether they are a child or an adult.
In fact most people [about 50%] are diagnosed between the age of 40-60.
Unfortunately, it is also a lifelong condition which you do not grow out of.