Hope for sufferers of coeliac disease
Coeliac Disease A gluten-free diet can be transformative for people with coeliac disease, according to Manchester GP, Dr John O’Malley.
He says: “If patients stick to the diet their quality of life can be transformed after years of tiredness and poor health. People don’t realise how ill they are until they’re well again. They regain their health and their confidence, which is a great encouragement to stay gluten-free.”
He points out that although it’s become trendy to go ‘gluten-free’ many people are not diagnosed properly and might not have the debilitating disease.
He says: ”People with coeliac disease do not choose to have a gluten-free diet to be trendy. If they had a different world, they would be eating bread and cakes like everybody else!”
Coeliac disease is a serious condition affecting countless thousands of people. “We have to do some myth busting. This is not a rare condition. It affects one per cent of the population and we don’t know how many undiagnosed people are out there.
“We need to think outside the box. Diarrhoea is not the only symptom of coeliac disease. It can show itself in lots of different ways including chronic fatigue.”
Dr O’Malley, who has studied the condition for many years, explains: “Coeliac disease is a hyper immunological disease against gluten found in wheat, barley and rye - the sticky part of the grain. The body attacks the gluten and in the process attacks the small intestine. It’s almost as if the bowel becomes ‘collateral damage’ when the body see gluten as a threat. That reaction causes inflammation and poor functioning of the small bowel.
He says symptoms are many and varied. “Traditionally GPs considered diarrhoea to be the main symptom. However there can be more nebulous symptoms such as feeling constantly tired, mouth ulcers, Irritable Bowel Syndrome, bloating, constipation, vitamin deficiencies, weight loss, vomiting or anaemia.
“Babies might suffer failure to thrive and children might have poor growth and poor concentration in school. Coeliac disease might also present as part of Type 1 diabetes, fertility problems and neurological symptoms.”
Dr O’Malley says there is a correct process for diagnosis, which is free and accessible through the NHS.
“GPs will often suggest tests based on symptoms or of a patient has relatives with coeliac disease. We offer a simple blood test and then, if positive, a gastroscopy to take samples for an intestinal biopsy which is the The Gold Standard.”
Dr O’Malley warns against self-diagnosis, testing kits ordered from the internet and diagnosis by alternative practitioners, which he views with scepticism.
“It is trendy now to say ‘I’m allergic to gluten’ but some people are making choices on poor information and inappropriate alternative testing could create dietary problems in the future.
“It’s important to be tested correctly by a GP. It’s not helpful when patients make their own diagnosis and go off gluten because it affects the results of medical testing.
“More testing in recent times gives the impression coeliac disease is increasing however more cases are now being detected now than in the past. But there is hope for a bright future for patients by adopting a gluten-free diet with the help of a trained dietician. And now because of increasing recognition of the problem, there is a vast range of gluten-free products for genuine sufferers to choose from.
"Now gluten-free foods are much more accessible in supermarkets and stores, and more restaurants and pubs are beginning to offer gluten-free meals. The accessibility for coeliac sufferers is certainly improving but we still have a considerable way to go".
Dr O’Malley said there is confusion between Irritable Bowel Syndrome (IBS) and coeliac disease because sufferers have similar symptoms. 1 in 4 patients with coeliac disease have previously been treated for IBS.
Dr O’Malley was a member of the National Institute for Clinical Excellence (NICE) committee in 2009 researching the assessment and management of coeliac disease. A new set of NICE recommendations were released in 2015
He recommends Coeliac UK as a “fantastic repository of information regarding the disease, products recipes and general support.”
Having coeliac disease doesn’t have to mean a life of misery. With proper diagnosis and dietary changes, your health and confidence can be restored.