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Diet Dilemma

Many people are putting themselves on a gluten-free diet, even though they don’t have coeliac disease. Is it wise to change one’s diet without professional advice?

QUESTION:

Many people are putting themselves on a gluten-free diet, even though they don’t have coeliac disease. It seems to have become the fashionable thing to do and those with digestive trouble find it helpful.

Is it wise to change one’s diet without professional advice?

ANSWER:

Coeliac disease is a hereditary disorder caused by sensitivity to the gliadin fraction of gluten that is found in wheat, rye and barley. This causes an inflammatory response in the lining of the small bowel. The incidence is 1/300 in European populations. The symptoms of coeliac disease usually emerge in childhood but in some cases may not occur until adulthood.

The result of the inflammation in the small bowel is malabsorption of certain nutrients such as iron, calcium, potassium, and sodium. This can lead to anaemia, osteoporosis, failure to thrive in infants, diabetes in adults and increased risk of cancer in the gastrointestinal system. It is therefore important to have the condition diagnosed before starting a gluten-free diet.

The diagnosis is made by a blood test, followed by endoscopy for a small bowel biopsy. If a gluten-free diet is already being consumed then the small bowel lining will appear normal and therefore give a false negative result, leading to a misdiagnosis.

If you suffer from coeliac disease it is important to have regular medical assessment, and get advice on what is safe to eat. If coeliac disease is not present, being on a gluten-free diet has no nutritional benefit and can be expensive.

If coeliac disease is suspected it is important to have an official diagnosis and suitable diet instated by a dietician. It is dangerous to start what is thought to be a gluten-free diet without guidance because it is possible that food containing gluten may still be consumed.

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