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Coeliac Disease

Coeliac Disease is defined as the mucosa of the small intestine adversely reacting to the gluten contained within rye, barley and wheat. It can also react to oats, but this is in a more decreased form.

This causes the decrease or wasting (atrophy) of the mircovilli (the membrane of the absorptive epithelial cells) of the small intestine (digestive tube).

This results in the malabsorption of nutrients, namely calcium and iron, weight loss and poor growth, as the small intestine decreases in its ability to absorb the nutrients from food.

It can affect any person, of any age, and it can be suggested that it is both a genetic and inheritable disease. Coeliac disease should be considered in all individuals who show the symptoms of malabsorption, suffer diarrhoea, anaemia and feel tired all of the time. Particular emphasis should be applied to those who have a family history of CD.

If it is untreated, the long-term effects can result in osteoporosis (weakening of bones), infertility, and a higher risk of adenocarcinoma (lung cancer). Further complications are osteopenia (decreased bone density), and due to anaemia (iron deficiency).

Coeliac disease (CD) can be misdiagnosed as the initial symptoms often mirror that of Irritable Bowel Syndrome, and each individual may show a variety of symptoms. The additional symptoms of anaemia and of a more general lethargy can provide a valuable indicator of Coeliac Disease, over IBS.

The symptoms and signs in adults are:
* Diarrhoea
* Fatigue
* Anaemia
* Distension of the abdomen
* Weight loss
* Muscle and joint pain

The symptoms and signs in children are:
* Diarrhoea
* Pain in the abdomen
* Vomiting
* No weight gain
* Refusing food

At present there is no cure for Coeliac Disease and the symptoms are managed with a life-long, and strict, gluten-free diet.

Basic gluten-free foods, for example, bread pasta, crackers, bread mix are essential in ensuring that a sufferer maintains both a varied and a nutritionally balanced diet.. The availability of gluten-free foods that are fortified with both iron and calcium assist is increasing the intake of nutrients.

Gluten free food is advisable, when compared to simply eliminating all gluten-free foods from the diet, because they provide nutrients, carbohydrates and a high level of energy intake.

The use of a dietician to review food intake, on an annual basis, is an ideal solution in coping with this life-long disease, as the poor compliance to dietary needs can lead to further long-term complications.