In coeliac disease, the body’s immune system attacks its own tissues when gluten is eaten. This causes damage to the lining of the gut so that the body is not able to absorb nutrients from food very well, explains Nicola Crawford-Taylor, dietitian at Coeliac UK. It is not an allergy or simple food intolerance, it’s an autoimmune condition which is associated with long-term health complications such as osteoporosis, infertility and small bowel cancer if left untreated, points out Crawford-Taylor. Gluten is a protein found in wheat, barley and rye. Some people with coeliac disease are also sensitive to oats. Coeliac disease is treated with a lifelong gluten-free diet.

While around 1 in 100 people have coeliac disease, crucially only 10-15 per cent are medically diagnosed, says Crawford-Taylor. “This can be due to a number of reasons including the fact that individuals themselves may not recognise that they have any symptoms,” she says. “Symptoms can include bloating, diarrhoea, wind, constipation, nausea, fatigue, anaemia, mouth ulcers, headaches, sudden weight loss, depression, joint/bone pain, recurrent miscarriage and infertility. You should visit your GP for testing if you have any of these symptoms.”

Coeliac disease is controlled by sticking to a strict gluten-free diet. Once gluten is removed the gut heals and improvements in symptoms and wellbeing usually occur within weeks. “A gluten-free diet is the only treatment for coeliac disease and should be taken seriously; it is not a fad diet. It’s not fair to expect people to have a small amount of gluten ‘just this once’, even a small amount can cause symptoms,” she points out. Eating out can be challenging. You should call the restaurant in advance, explaining your need for a gluten-free diet, suggests Crawford-Taylor. Baking with gluten-free flours can be more difficult as gluten gives bread, cakes and pastry their texture. Try experimenting with different flours and ingredients.

“There is no reason why you can’t enjoy delicious, tasty food on a gluten free diet,” says Crawford-Taylor. “It can be an opportunity to try new foods and experiment with different ingredients. It’s easy to adapt recipes by switching gluten-containing ingredients for those that don’t contain gluten, and a wide range of gluten-free products are now available in supermarkets.”