The Gluten Free Baker
At Bodhi’s we use our vast baking experience and continuous development to bring more exciting, better tasting, and nutritionally more beneficial, gluten free ingredients to our products for the often neglected nutritionally sensitive customer. Whilst maintaining strict testing to maintain our gluten free range remains as safe as always for the people we serve.
INFORMATION – ABOUT COELIAC DISEASE
Coeliac disease is a medically diagnosed condition of an intolerance to gluten in the diet. Gluten is the protein component of wheat, rye, barley and oats. In people with coeliac disease, after consuming gluten, the small intestinal lining (villi) becomes inflamed and the normal appearance changes so that it has a flattened appearance. A strict gluten-free diet can reverse these abnormalities, and is the only recognised treatment for coeliac disease.
Prevalence of coeliac disease is likely to be underestimated in Australia, and is probably in the order of 1 in 100, with diagnosis rates increasing. Coeliac disease also occurs in 10% of first-degree relatives. More than 99% of people with coeliac disease have the genetic profile of HLA DQ2 or DQ8.
It is becoming increasingly evident that there is indeed a broad spectrum of presentations of coeliac disease. Increasing numbers of adults are being diagnosed, whereas years ago it was considered a disease that was only diagnosed in children. Coeliac disease can present at any age and the variability and often vagueness of symptoms can present a diagnostic challenge to many medical practitioners. Presentation can include:
Gastrointestinal symptoms such as:
- Loose stools/diarrhoea, or constipation (or a combination of both)
- Abdominal pain
These can often be labeled as irritable bowel syndrome. It is strongly recommended all people experiencing symptoms of irritable bowel syndrome be investigated for coeliac disease.
Alternatively, it may present with no gastrointestinal symptoms at all.
Other symptoms can include:
- Lethargy and fatigue
- Poor weight and growth gain in children
- Iron, folate, zinc, Vitamin D deficiency.
- Osteopaenia and osteoporosis. Approximately 5% of patients being investigated for reduced bone mineral density have undiagnosed coeliac disease as a cause.
- Delayed menarche or recurrent miscarriages in women
- Infertility (in males and females)
- Recurrent mouth ulceration
- Dental enamel defects
The gold standard for diagnosis is a small bowel biopsy (the doctors will look for histological evidence of villous atrophy +/- infiltration of lymphocytes). This involves a special camera being passed down the oesophagus, past the stomach, and into the first part of the small bowel. There, small samples of the lining of the small bowel are taken and investigated under the microscope. If the biopsy samples show flattening of the lining, then it confirms coeliac disease.
There are some blood tests that can be performed to help screen for coeliac disease in “at risk” populations (eg. family members, people with diabetes, etc). However these are generally not ideal for diagnosing coeliac disease, as there can be false positives and false negatives. Blood tests including IgA anti-endomysial or tissue transglutaminase antibody tests can be ordered (“coeliac serology”). Total IgA antibody test should also be performed to help validate results. The small bowel biopsy is still considered the best method for diagnosing coeliac disease.
THERE IS NO ROLE FOR A TRIAL OF GLUTEN-FREE DIET WITHOUT A PRECEEDING BIOPSY