Coeliac disease is an autoimmune disorder in which gluten triggers an inflammatory process in the small intestine that will lead to atrophy of lining of the small intestine. This can lead to malnutrition. Repeated ingestion of gluten or a late diagnosis can lead to serious side effects and health problems. Coeliac disease is associated with a higher risk for other autoimmune disorders, as well as side effects like anaemia and vitamin deficiencies, osteoporosis, tooth enamel defects, infertility, stunted growth in children and much more. The only treatment for coeliac disease is a strict gluten-free diet for life after diagnosis. With the rate of coeliac disease estimated at 1 in every 100 people worldwide, it is a relatively common condition which is still vastly under-diagnosed. There is still the need for awareness, which is experienced directly by people who suffer from this condition in everyday life, and especially when dining out.
Gluten is present in so much more than flour and bread. Wheat is the most widely grown grain worldwide and is eaten in the form of bread, pasta, baked goods and more. Wheat, together with rye and barley, contain a protein composite called gluten that is a very popular ingredient in food processing due to its properties of elasticity and the ability to trap air. In reality, gluten-containing ingredients can be used deliberately in any processed food or beverage. It is important to read ingredients lists of any product used- even if it does not seem obvious that it would contain gluten.
Removing a bun from a burger or removing the croutons from a salad is not enough. Even crumbs of gluten containing food are enough to trigger the autoimmune response in people with coeliac disease. So, we cannot just remove the crust of a pie and eat the filling, or eat a slice of gluten free bread that has been toasted in the same toaster as normal bread. When preparing food for a person with coeliac disease, all utensils and preparation surfaces must be thoroughly clean, any person preparing or handling the food must have clean hands and clothing and all ingredients must be gluten free.
Just because we do not have an immediate reaction to gluten it does not mean we are fine. Coeliac disease is not an allergy. That means that the response will not occur within minutes to hours. It can occur anywhere from hours to days after gluten exposure. There might not be any obvious symptoms at all. However, when gluten is consumed, even in small quantities, the body mistakenly attacks itself and repeated exposure to gluten can have serious consequences.
Cooking does not kill gluten. Spraying surfaces or utensils with an antibacterial solution will not kill gluten either. Gluten is not a living organism. It is a protein. It can only be removed with thorough washing and cleaning with soap and water. Sometimes separate utensils are needed like in the case of colanders, toasters or chopping boards.
Coeliac disease is not a severe form of gluten sensitivity. The spectrum of gluten-related disorders includes coeliac disease, gluten sensitivity and wheat allergy. However, gluten sensitivity and coeliac disease are separate conditions with different management strategies and different lifestyle implications. Neither of these two conditions is an allergy to wheat. Gluten sensitivity is defined as a condition in which adverse symptoms are experienced with the ingestion of gluten, and in which relief of symptoms is experienced when gluten is removed from the diet. It is diagnosed once coeliac disease and wheat allergy have been ruled out. Although symptoms are similar to those of coeliac disease, no long-term damage appears to occur if gluten is ingested. Symptoms of gluten sensitivity occur within hours or days after ingestion of gluten containing grains and disappear rapidly when these grains are eliminated from the diet. It also appears that gluten ingestion does not result in the atrophy of the lining of the intestine like in coeliac disease. One of the most controversial topics on the subject is whether it is actually gluten that causes the symptoms in people with non-coeliac gluten sensitivity. Some reports have indicated that gluten might not actually be the culprit. It has been proposed, and there is mounting evidence that other proteins that are unique to gluten containing cereals can elicit a response that leads to gluten sensitivity.
Our diet is not boring. Although there is a huge range of gluten-free products on the market, we can create mouthwatering dishes with naturally gluten free ingredients that would rival any gluten containing meal. All that is needed is a bit of knowledge and creativity. Naturally, gluten free foods include meat, fish, fruit and vegetables, eggs, most cheeses, milk, rice and other gluten free grains. Natural nuts, seeds, and lentils are also naturally gluten free but can be contaminated with gluten during packaging. Many marinades and sauces do contain gluten although gluten free substitutes do exist. Some gluten free cereals include rice, corn, millet, sorghum, teff, amaranth, buckwheat, quinoa and tapioca.
Just little bit of gluten will hurt.
It might be difficult to comprehend, but even cross contamination of a gluten free food with gluten-containing food can be harmful to a person with the coeliac disease. A strict gluten-free diet is an absolute necessity for people with coeliac disease. It is not a choice and we are not being fussy.