If you or someone you love has been recently diagnosed with coeliac disease, you could be eligible to receive gluten free foods on prescription. Simply select your country of residence, and, if you live in England, fill in your postcode to check if your area is prescribing.
Your country is prescribing gluten free foods*. Request your Glutafin Taster Box by clicking the button below to sign up.
* Please note: local policies are constantly updated, and issuing a prescription is at the discretion of your GP.
With a wider awareness of gluten and wheat as possible dietary triggers of symptoms in some people, there is a potential for lots of confusion! Dr Google has lots of answers to what could be causing symptoms such as bloating, abdominal pain, diarrhoea and constipation, but what are the facts? Which conditions could be causing these symptoms, and when should you be consulting your doctor to find out if you could be suffering from one of them?
Thankfully, here at Glutafin, we have an expert in gluten related disorders. Our Dietitian, Melissa, explains the spectrum of gluten related disorders and examines the medical evidence related to each of them. Coeliac disease, wheat allergy, wheat intolerance, gluten sensitivity and IBS are put under the microscope.
But first, some advice from Melissa…
‘Before you make any changes to your diet, it’s incredibly important that you speak to your GP. Early exclusion of gluten could lead to coeliac disease not being detected, which will be detrimental to your health at a later date’.
Read our article below on why getting a diagnosis of coeliac disease is important.
Diagnosis of coeliac disease
Coeliac disease is an autoimmune condition caused by an intolerance to gluten, a protein found in wheat, rye and barley.
Essentially, gluten triggers an immune reaction in people with the condition, which results in damage to the lining of the gut. The villi lining in the small intestine would normally help to absorb nutrients from the food. However, in untreated coeliac disease, villi become inflamed and flatten meaning the body cannot absorb nutrients as effectively. Symptoms of coeliac disease include diarrhoea, constipation, stomach pain, bloating, anaemia and headaches. If left undiagnosed, coeliac disease can result in serious nutrient deficiencies, poor bone health (osteoporosis) and infertility.
Coeliac disease is estimated to affect 1 in 100 people in the UK and can be diagnosed by a blood test followed by a biopsy of the gut. Coeliac disease is managed by a strict lifelong gluten free diet.
Read more on coeliac disease
Wheat allergy is an allergic reaction to the proteins in wheat.
There are different forms of wheat allergy, and symptoms will depend on how it presents, for example, whether it affects the gut (classic food allergy) or respiratory system (respiratory allergy or Baker’s asthma) and can include hives, asthma, hay fever, abdominal cramps, nausea and vomiting. Wheat allergy is a rare condition thought to affect less than 1% of the population. The condition can be diagnosed by a skin prick test and a blood test.
Wheat allergy is managed by following a wheat free diet.
Wheat intolerance is an adverse reaction to one or more components within the wheat grain, with symptoms usually involving the gut. The terms wheat allergy and wheat intolerance are often used interchangeably, however there are important differences between allergies and intolerances.
Allergies involve the immune system and can affect numerous parts of the body, causing a range of symptoms, some of which may be life threatening.
Intolerance symptoms tend to be less serious and are often limited to the digestive system. Symptoms of wheat intolerance often include IBS-type complaints, such as bloating, abdominal pain and diarrhoea.
Accurately identifying wheat intolerance can be difficult as there are no reliable tests available to confirm the diagnosis. Over recent years, researchers have begun to reclassify this condition as ‘non-coeliac wheat sensitivity’ (see below) and diagnosis is largely based on the improvement of symptoms following the removal of wheat.
As symptoms are very similar to coeliac disease and wheat allergy, it’s essential these conditions are ruled out with the appropriate tests before removing wheat from the diet.
Gluten sensitivity, sometimes called non-coeliac gluten sensitivity or non-coeliac wheat sensitivity is a newer condition in the spectrum of gluten related disorders.
Symptoms such as bloating, abdominal pain, diarrhoea, headaches, ‘brain fog,’ skin rashes and exhaustion, could be due to gluten sensitivity.
Diagnosis of gluten sensitivity is difficult because, unlike coeliac disease and wheat allergy, there are currently no reliable blood tests available to confirm a diagnosis of gluten sensitivity. Typically, gluten sensitivity is diagnosed by first excluding coeliac disease and wheat allergy. Following this, If symptoms are still thought to be related to gluten, then a gluten free diet could be trialled with the guidance of your GP and/or a dietitian.
Population-based surveys suggest that gluten sensitivity may be much more common than coeliac disease, although more research is needed to understand the true prevalence of the condition.
More research also needs to be conducted to establish how strict adherence to a gluten free diet needs to be for someone with gluten sensitivity and also whether the condition is temporary or lifelong (as with wheat allergy and coeliac disease).
Irritable Bowel Syndrome (IBS) is a term used to describe a collection of gut symptoms (e.g. bloating, constipation, diarrhoea) that cannot be explained by any other condition. There are no formal tests to diagnose IBS.
IBS affects approximately 10-20% of the population and can vary considerably in its severity. Medical advice for people with IBS is to try a healthy diet in the first instance, as symptoms can be triggered by fatty foods and alcohol. If symptoms persist, GP’s may refer patients to a dietitian, who may recommend following a low FODMAP diet, a diet that involves restricting certain foods in order to alleviate symptoms.
There is some evidence that following a gluten free diet can alleviate symptoms of IBS; however, this is not currently part of national guidance for the condition.
In the past, coeliac disease was often misdiagnosed as IBS. This has improved since the guidance was introduced that advises doctors to always test for coeliac disease before diagnosing IBS. Unfortunately, there are still instances where this happens, which is why it is very important to first have a blood test to exclude coeliac disease.
People with coeliac disease may also, in rare cases, suffer from IBS.
We hope we’ve provided a useful overview of the differences between gluten related disorders. If you have any questions, please do contact us; we appreciate it’s a complex topic!
Read more on how to cope with IBS
No, gluten allergy is not a recognised condition. Coeliac disease is not an allergy or intolerance, it is an autoimmune condition where the body’s immune system attacks its own tissues when someone consumes gluten. The only treatment for coeliac disease is a lifelong gluten free diet. Wheat allergy is a reaction to the proteins in wheat, thought to affect less than 1% of the population.
The first step for diagnosing coeliac disease or a wheat allergy is a blood test with your doctor. It is very important not to exclude gluten from your diet before a formal diagnosis of coeliac disease. If blood tests are negative for coeliac disease and wheat allergy, you may have gluten sensitivity or IBS. Your GP will be able to help you to discover what the cause of your symptoms could be and if they are related to gluten.