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Alternative Names
• Celiac Sprue
• Non-tropical sprue
• Gluten intolerance
• Gluten-sensitive enteropathy
What is it?
• Celiac disease is a digestive disease that damages the
small intestine and interferes with absorption of
nutrients from food. People who have celiac disease
cannot tolerate gluten, a protein in wheat, rye, and
barley. Gluten is found mainly in foods but may also be
found in everyday products such as medicines, vitamins,
and lip balms.
• This small intestine is shaded on the
right.
Continued…
• When people with celiac disease eat foods or use
products containing gluten, this causes inflammation in
the intestine and their immune system responds by
damaging or destroying villi, the hair-like structures on
the lining of the small intestine. Nutrients from food are
absorbed by the villi. If the villi are damaged, the person
cannot absorb nutrients and ends up malnourished, no
matter how much he or she eats.
• Villi on the lining of the small intestine help absorb nutrients
Causes
• Celiac disease is both a disease of malabsorption—meaning
nutrients are not absorbed properly—and an abnormal
immune reaction to gluten. Normally, the body's immune
system is designed to protect it from foreign invaders. When
people with celiac disease eat foods containing gluten, their
immune system forms antibodies to gluten which then attack
the intestinal lining. Celiac disease is genetic, meaning it runs in
families. Sometimes the disease is triggered—or becomes active
for the first time—after surgery, pregnancy, childbirth, viral
infection, or severe emotional stress.
• All this being true, many doctors and scientists agree that the
definite cause of celiac disease still remains a mystery. They
cannot prove the exact cause of this disease.
Symptoms
Symptoms of celiac disease vary among different sufferers and include:
• Digestive problems (abdominal bloating, pain, gas, diarrhoea and
weight loss)
• Severe skin rashes
• Anemia (low red blood cells)
• Muscle/ Skeletal problems (muscle cramps, joint and bone pain)
• Growth problems
• Seizures
• Tingling sensation in the legs (caused by nerve damage and low
calcium)
• Ulcers (sores in the mouth)
• Missed menstrual periods.
Risk Factors
Risk factors are anything that has been identified as increasing an
individual's chance of getting this disease/illness.
Risk factors for Celiacs disease include:
• Family History of Celiac- When someone in the family has had the
disease you have a greater risk of inheriting it.
• Italian race- celiac is common in Italy and descendants, because they
consume large amounts of gluten; they have a gluten based diet, for
example they eat large amounts of pasta which contain wheat and
therefore gluten.
• Family history of autoimmune diseases (the immune response of the
body against a substance normally present in the body)- if someone
in the family has an autoimmune diseases it increases the risk of
inheriting celiac because celiac is an autoimmune disease.
Celiac is more common in people who have:
• Type 1 diabetes
• Autoimmune thyroid disease
• Down syndrome
• Microscope colitis
• People with certain genes (HLA-DQ2 and DQ8)
Treatment
•IMPORTANT: the only
medically acceptable treatment
for celiac disease is a 100%
pure gluten free diet for life.
Foods to avoid
A person with celiac disease should avoid all foods that contain gluten. Some foods that
may contain gluten include:
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Meat products – any products prepared with breadcrumbs or batter, sausages and
other processed meats, thickened soups, meat pies and frozen meals.
Dairy products – malted milk, some cheese spreads, ice-cream in a cone and some
soymilks.
Fruits and vegetables – canned and sauced vegetables and fruit-pie filling.
Cereal and baking products –wheat bran, barley, oats, porridge, breakfast cereals
containing wheat, rye, corn or rice cereals containing malt extract, some icing sugar
mixtures and baking powder.
Pasta and noodles – spaghetti, pasta, lasagne, gnocchi, hokkein noodles, soba noodles
and two-minute noodles. (This is evident of the reasons why italian have a much
higher risk in the disease).
Bread, cakes and biscuits – all bread, cakes and biscuits prepared with flours from a
gluten source.
Condiments – malt vinegar, some mustards, relishes, pickles, salad dressings, sauces,
gravy and yeast extracts.
Snacks – liquorice, some lollies and chocolates, packet savoury snacks and some
flavoured potato and corn chips.
Drinks – cereal coffee substitutes, milk drink powders.
Alcoholic drinks – beer, stout, ale, Guinness and lager (most beers contain gluten).
Naturally Gluten Free Foods
Despite the restrictions, a person with celiac disease can still enjoy a wide and varied diet.
Some gluten free foods that people with celiac disease can enjoy include:
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Meat products – unprocessed meat, fish, chicken, bacon, ham off the bone and meats
that are frozen or canned but with no sauce.
Dairy products – eggs, full cream milk, low fat milk, evaporated milk, condensed milk,
fresh cream, processed or block cheese and some custards and soymilks.
Fruits and vegetables – fresh, canned or frozen but not sauced; fruit juices, nuts and
peanut butter.
Cereal and baking products – corn flour, rice (all types), rice flour, breakfast cereals
made from corn and rice without malt extract.
Bread, cakes and biscuits – most rice crackers, corn cakes, rice crispbreads, corn tortillas
and corn taco shells.
Pasta and noodles – gluten free pasta, rice noodles, rice or bean vermicelli and 100 per
cent buckwheat noodles.
Condiments – tomato paste, jam, honey, maple syrup, cocoa, all kinds of vinegars
(except malt), some sauces and some salad dressings.
Snacks – plain chips and corn chips, popcorn and plain chocolate.
Drinks – tea, coffee, mineral water, wine, spirits and liqueurs
Individual Costs
Direct Costs
• It is more expensive to buy gluten free foods.
We wanted to see the evidence of this so Laura and I looked on the Safeway
website and found that normal Kellogg's cornflakes were worth $3.15, where
as gluten free cornflakes were $5.90. For a packet of spaghetti it is $2.58 and
for the same brand and quantity but gluten free it is $4.29. This is a
considerable difference between the prices and would make a big difference
when doing the grocery shopping for someone with celiac disease, it would
make the shopping so much more expensive when buying gluten free food.
Indirect Costs
• If you suffer from celiac disease there would not be a very wide range of
food and the quality might not be as good as if you didn’t have this disease,
there would be big restrictions of the kind of foods the sufferer could eat.
• People with this disease would suffer the symptoms of celiac such as stomach
cramps if they did not follow their strict diet and would therefore need time
off work. This could turn out to be a problem because celiac is a life long
disease and they may consistently be taking time off work and getting
behind.
Community Costs
Direct Costs
• If a person that suffers from celiac disease does not abide by their diet rules
(not consuming gluten) they may experience the effects of the disease. If
these people are sick they will, as I said before, need time off work which
costs the workplace money as they would have to continually pay for these
people to have sicks days.
Indirect Costs
• Again these people may not be able to work which would, in turn, cost the
government lots of money and lead to the government being made to give
pensions to these people because of their illness. The government could, in
the long run, loos tax payers because people with the disease may have to
stop working because they can’t follow the regulations of the diet.
Australian Rates
• Celiac disease affects approximately 1 in 100 people in Australia but 4
out of 5 (80%) people don't know they have it. This means that
approximately 200,000 Australians have celiac disease but don’t yet
know it.
• Celiac disease is one of the most under-diagnosed, yet most common
chronic diseases. Left untreated, the possibility of severe problems
such as bowel cancer and osteoporosis increases.
• A first-degree relative (parent, brother, sister, child) of someone with
celiac disease has about a 10% chance of also having the disease. If
one identical twin has celiac disease, there is an approximate 70%
chance that the other twin will also be affected (but not necessarily
diagnosed at the same time).
• Celiac disease affects Caucasians and west Asians. It is uncommon in
the Oriental Asian and full-blood Australian Aboriginal populations.
Strategy designed to eliminate
the problem
• The Celiac Society of Australia Inc owns the registered trademark to
the two logos displayed. The society undertakes a program of
approving gluten free products.
• The crossed grain logo is recognised world wide as the symbol for
'gluten free' and thereby gives a clear indication that the product has
been tested to standards approved by The Coeliac Society. The logo
is immensely reassuring to those with celiac disease or non-celiac
gluten intolerance.
• AGAIN, THE ONLY WAY TO ELIMINATE THE PROBLEM IS TO
AVOID ALL FOODS CONTAINING GLUTEN.
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• Consult dietitians and national celiac disease societies for lists of
gluten free foods. Read the food and product labels before buying or
consuming any product. This is necessary because a manufacturer
may change a product's ingredients at any time. A product that was
gluten-free in the past may now contain gluten. Even branded
products may be gluten free in one country but contain gluten in
another country. If one is not certain after reading the labels, call the
manufacturer.
• Because patients with severe malabsorption can develop vitamin and
mineral deficiencies, vitamin and mineral supplements are important.
All patients should take a multivitamin daily.
Where to get help
• Your doctor
• Gastroenterologist
• An qualified practising dietitian, contact
the Dietitians Association of Australia
• The Coeliac Society in Victoria Tel. (03)
9808 5566 or 1300 458 836
Biliography
• http://www.coeliacsociety.com.au/
• http://www.betterhealth.vic.gov.au/bhcv2
/bhcarticles.nsf/pages/Glutenfree_diet?open
• http://digestive.niddk.nih.gov/ddiseases/pu
bs/celiac/index.htm
• http://www.yourzone.com.au/content/He
alth_conditions/Coeliac_Disease/informatio
nonCoeliacDisease.html