Coeliac FAQ

Answer: Whilst the blood test used to screen for coeliac disease is sensitive and specific, it is not 100% accurate. In addition, one of the coeliac antibodies which is often checked to indicate the possibility of coeliac disease can also be raised in certain other conditions.

The biopsy enables healthcare professionals to take a small sample of the lining of of the gastrointestinal tract to check for characteristic changes associated with coeliac disease. This confirms the diagnosis which is beneficial as the management of the condition involves a lifelong dietary change.

Answer: Coeliac disease does run in the family - evidence suggests that there is an increased risk of 1 in 10 when coeliac disease exists in close family members ie parents, siblings, children etc- (ie first degreee relatives).

If you suspect a family member has coeliac disease, consult your GP and do not change their diet.

Answer: Food hypersensitivity is the umbrella term for adverse reactions to foods.

A food allergy involves the body's immune system and the body is usually reacting to the protein part of the food. Reactions can be rapid and severe and in some cases, life threatening.

A food intolerance does not involve the body's immune system and is usually a reaction to a non-protein part of food e.g sugar. Reactions can be acute and severe but are rarely life-threatening. An example of this is lactose intolerance (sugar in milk).

Coeliac disease is an autoimmune condition triggered by an intolerance to gluten, a protein found in wheat, rye and barley. The intolerance results in the lining of the small intestine becoming inflamed and stops food from being absorbed properly. This can result in nutritional deficiencies.

Answer: Dermatitis herpetiformis (DH) is a skin condition caused by an intolerance to gluten and is considered as the skin ‘symptom’ of coeliac disease. It affects around 1 in 10,000 people. Symptoms of dermatitis herpetiformis include an itchy skin rash made up of raised red patches which may well blister. The rash tends to occur on elbows, knees and buttocks and usually occurs on both sides of the body.

Answer:

If you are still experiencing problems, you should consult your GP who may refer you back to a consultant or dietitian for a dietary review. This is just to ensure that you are not accidently ingesting gluten.
 

Answer: Continued symptoms that you felt before being diagnosed will be the main discomfort if you do not follow a gluten free diet.

Continued inflammation of the lining of the GI tract can occur which can lead to an increased risk of developing associated long term health complications such as nutritional deficiencies, osteoporosis and malignancy.

By strictly following a gluten free diet, the risk of developing complications is reduced.

Answer: Gluten free foods can contain a specially manufactured ingredient called gluten free wheat starch. This ingredient is manufactured specifically to be suitable for people with coeliac disease and is sometimes referred to as Codex wheat starch.

Products made with Codex wheat starch (such as our Select range) benefit from better baking qualities and a lighter texture.

Answer: There are several ways that you can check to see if a product is safe to eat.

All pre-packaged foods in the UK are required by European law to list common food allergens where used on the back of pack. Therefore if a product contains gluten, it will tell you on the packaging.

Foods that are safe to eat:

• Glucose syrups derived from wheat or barley (including dextrose)
• Wheat-based maltodextrins
• Distilled ingredients made from gluten-containing cereals, for example alcoholic spirits

The above ingredients are fine to include as they are very highly refined and rtherefore not thought to be harmful to those with coeliac disease.
Cereals that are not safe to eat:

• Gluten
• Wheat
• Rye
• Barley
• Oats (consult your GP to discuss whether or not you should include oats in your diet)

You can also consult the Coeliac UK Food and Drink Directory which lists all safe foods in supermarkets and catering. Coeliac UK is the charity that supports people with coeliac disease. If you choose to become a member of Coeliac UK, this directory is sent as part of your membership package.


Some manufacturers do also include additional helpful information in the form of a 'Contains' box or Allergy advice box near the ingredients string.

Answer: Secondary lactose intolerance is often found in individuals with untreated coeliac disease due to the inflammation of the lining of the small intestine. This is because lactose (a milk sugar) is digested by lactase, an enzyme located in the lining of the small intestine. In untreated coeliac disease, the lining of the small intestine is affected and results in less lactase being produced- as a result not all of the lactose is broken down and this can lead to intolerance.

On diagnosis and treatment of coeliac disease, secondary lactose intolerance can resolve following repair of the gut and subsequent production of lactase again.

Many people find that they can tolerate lactose again after a while of being on a gluten free diet. Please consult your dietitian for specific personal advice.

Answer: In order for the tests for coeliac disease to be accurate it is important for gluten to be included in the diet prior to test being undertaken to avoid false negative results.

Please consult a medical professional e.g. a GP for specific individual advice. However, as a guide, in adults 4 slices of gluten-containing bread a day for a minimum of 2 weeks should be enough gluten to produce an accurate test. Please consult a medical professional e.g. a GP for specific individual advice However, the NICE Guidelines on Recognition & Assessment of coeliac disease state: People should follow a gluten-containing diet including some gluten in more than one meal every day for a minimum of 6 weeks before testing; however, it is not possible to say exactly how much gluten they should eat.

Answer: When you eliminate gluten from your diet, your body will start to absorb nutrients from food that it previously didn't. This can mean that you start to put on a little weight, but this is perfectly normal and signifies that your body is recovering.

A healthy diet is crucial to maintain a healthy weight. Here are a few tips:

• Enjoy your food
• Remember, variety is the spice of life
• Don’t overeat
• Eat foods rich in starch and fibre to fill you up
• Add plenty of fruit and veg to your diet
• Keep fatty foods to a minimum
• Sugary foods and drinks should be thought of as a treat
• Don’t over-salt your food, and enjoy salty foods such as cheese, bacon or crisps in moderation
• If you drink, enjoy alcohol responsibly
If you put on excessive weight or are concerned, please speak to your dietitian.

Answer: A gluten free diet can often lack fibre due to the restriction of cereals and cereal products. This food group contributes approx 42% of daily fibre intake on average.

Some Glutafin products are high in fibre, so incorporating these into your daily diet will help to ease constipation. Just look for the 'high in fibre' tick on the product pages.

Fruit and vegetables are also a good source of soluble fibre, so make sure you include plenty of these in your diet.

Answer: Your dietitian understands how daunting and confusing it can be to embark on a new gluten free lifestyle but they are there to help guide you with information and support. They will provide expert advice on following a gluten free diet, how to get products on prescription and ensure that any questions you have are answered fully. Try to be prepared and take a list of questions with you, so you don't forget to ask any while you are in your appointment. It is also likely you will have a follow-up visit to the dietitian.

Answer: As we're sure you can appreciate, developing gluten free foods which taste and look similar to gluten -containing alternatives requires a lot of time and expertise. We constantly review the nutritional profile of our products at any product development opportunities. In addition, some of the products tend to have a longer shelf life than standard equivalent products and therefore to ensure the products are safe to eat, we sometimes have to add preservatives.

Answer: All Glutafin products meet the criteria required for products to be labelled as ‘gluten free’ under the updated Codex Standard and new EC legislation. This will ensure the Glutafin range of products containing wheat starch continue to be available to individuals with coeliac disease.

Glutafin products have always complied with the Codex Standard for gluten-free foods. This standard previously advised that products labelled as ‘gluten free’ must contain less than 200mg per kg gluten (also referred to as parts per million- ppm). In July 2008 a new Codex Standard was adopted following a review of scientific evidence and a dual standard was agreed. There are two categories in the new Codex Standard:

1) Foods containing less than 20ppm gluten which can be labelled ‘gluten free’
2) Foods containing between 21-100ppm gluten which can be labelled ‘very low gluten’

In the absence of legislation the international Codex Standard for gluten-free foods has been an important means of ensuring suitability and safety of products for individuals with coeliac disease. However, in January 2009 a European Commission (EC) Regulation on gluten-free foods was adopted, based on the Codex Standard. This piece of legislation allows a 3-year transition period to enable manufacturers to make all necessary changes to product ranges and labels before the legislation becomes mandatory from 1st January 2012.

All food products not exceeding 20ppm gluten will be able to be labelled ‘gluten free’. This will apply to mainstream products (such as crisps, soups etc), pure, uncontaminated oat products and specialist substitute products, including products containing Codex wheat starch, which meet the relevant criteria.

Only specialist substitute products which have been processed to reduce the gluten content, for example, those containing Codex wheat starch, with a gluten level of between 21-100ppm gluten will be able to use the labelling term ‘very low gluten’.