Gluten Free or Coeliac Recipes -

Gluten Free or Coeliac Recipes

Coeliac disease spelled celiac disease in North America, is an autoimmune disorder of the small intestine that happens in genetically predisposed people of all ages from middle infancy onward. Symptoms include chronic diarrhoea, failure to thrive (in children) and fatigue, but these could be absent, and symptoms in other organ systems have been described. A growing percentage of diagnoses are being made in asymptomatic persons because of increased screening. Coeliac disease is attributable to a reaction to gliadin, a prolamin (gluten protein) found in wheat and similar proteins found in the crops of the tribe Triticeae (which includes other cultivars such as barley and rye). Upon exposure to gliadin and certain other prolamins, the enzyme tissue transglutaminase modifies the protein and the immune system cross-reacts with the small-bowel tissue, causing an inflammatory reaction. That leads to a truncating of the villi lining the small intestine (called villous atrophy). This interferes with the absorption of nutrients, since the intestinal villi are responsible for absorption. The only known effective treatment is a lifelong gluten-free diet. While the disease is caused by a reaction to wheat proteins, it's not the same as wheat allergy.

Severe coeliac disease leads to the characteristic symptoms of pale, loose and greasy stool (steatorrhoea), weight-loss or failure to gain weight (in young children). Individuals with milder coeliac disease may have symptoms that are much more subtle and occur in other organs instead of the bowel itself. Finally, it is possible to have coeliac disease without any symptoms whatsoever. Many adults with subtle disease have only fatigue or anaemia.

Wheat subspecies (such as spelt, semolina and durum) and related species like barley, rye, triticale and Kamut also induce symptoms of coeliac disease. A small minority of coeliac sufferers also react to oats. It is most probable that oats produce symptoms due to cross contamination with other grains in the fields or in the distribution channels. Generally, oats are therefore not recommended. Other cereals like maize (corn), quinoa, millet, sorghum, teff, amaranth, buckwheat, rice and wild rice are safe for patients to consume. Non-cereal carbohydrate-rich foods such as potatoes and bananas do not contain gluten and do not trigger symptoms.

There are a number of tests that can be utilized to help in diagnosis. The extent of symptoms may determine the order of the tests, but all tests lose their usefulness if the patient is already taking a gluten-free diet plan. Intestinal damage begins to heal within weeks of gluten being removed from the diet and antibody levels decline over months. For those who have already started on a gluten-free diet, it may be required to perform a re-challenge with some gluten-containing food in a single meal each day over 2-6 weeks before repeating the investigations.