Coeliac Disease

1 in 100 people in the UK have coeliac disease but only 36% are diagnosed. Coeliac Awareness Month aims to find those people who have not been diagnosed and get them on the road to recovery.

Coeliac disease can display differently for everyone - not only in the wide range of symptoms that can be experienced but in the strain caused by living with unexplained health problems. In coeliac disease, the individual's immune system reacts abnormally to gliadin, a peptide protein found in wheat, rye, barley and spelt. In these genetically predisposed individuals, the gliadin peptide is not digested properly which leads to some inflammation in the gut initiating an enzyme in the villi of the gut called transglutaminase to “deamidate” (change) the gliadin peptide, which in the process binds to the transglutaminase enzyme itself. Now the immune system reacts against gliadin as well as its own enzyme, by creating antibodies, as such is classified as an autoimmune disease. 

A result of the on-going inflammation and tissue damage leads to a variety of symptoms and consequences; such as poor nutrient absorption, vitamin and mineral deficiencies (iron deficiency is very common) and thinning of the bones (osteoporosis). There is also an increased risk of developing other autoimmune diseases (such as type 1 diabetes and thyroid disease). Fortunately, timely diagnosis of coeliac disease and treatment with a strict, lifelong gluten free diet can prevent or reverse these issues.

Gluten Intolerance

A gluten-intolerance, also referred to as non-coeliac gluten sensitivity (NSGS),  shares many symptoms with coeliac disease however, individuals with non-celiac gluten sensitivity have more extraintestinal or non-GI symptoms, such as headache, brain fog, joint pain, and numbness in the legs, arms or fingers. 

In NCGS, individuals can still produce IgG or IgA antibodies against gliadin or other peptides, but do not make the antibody against the transglutaminase enzyme. As such when a biopsy is performed on that patient, the sample is absolutely normal. Therefore, NCGS is very difficult to detect because the classic blood test, which confirms diagnosis of coeliac disease, is negative because transglutaminase IgA is negative—and they do a biopsy and the biopsy is negative.

Being gluten-intolerant or NCGS isn’t as black and white as coeliac. It has been discovered that wheat and other gluten grains are made up of more than 100 different components that have the potential to cause a reaction. A person can react to only one of the many proteins in wheat, or a combination of proteins, peptides, and enzymes associated with wheat (and other grains). 

A gluten intolerance can cause problems with the digestive system and left unchecked or managed can lead to more permanent damage and autoimmune progression. 

The treatment for NCGS is to eat a gluten-free diet, and can be supported through taking certain vitamins and supplements to make sure the body is getting all the nutrients it needs to stay healthy. 

Taking supplements such as GlutenFlam by Apex Energetics that feature powerful DPP IV (dipeptidyl peptidase IV) digestive enzymes paired with especially targeted bioflavonoids, can be helpful to address unintentional gluten exposures.

Wheat Allergies

A food allergy is an immune system reaction that happens soon after eating a certain food. Even a small amount of the allergy-causing food can trigger symptoms such as digestive problems, hives or swollen airways. In some people, a food allergy can cause severe symptoms or even a life-threatening reaction known as anaphylaxis. 

It’s easy to confuse a food allergy with a much more common reaction known as a food intolerance, that is more related to a lack of a digestive enzyme. While bothersome, food intolerance is a less serious condition that does not involve the immune system.

Food allergies are divided into three categories - IgE-mediated food allergy, Non-IgE-mediated food allergy, Mixed IgE and non-IgE-mediated food allergies.

An IgE-mediated food allergy is the most common type triggered by the immune system producing an antibody called immunoglobulin E (IgE). Upon subsequent exposure to the same food allergen, the allergen binds to the IgE antibodies on the mast cells, triggering these cells to release various chemical substances, including histamine and other inflammatory mediators. This release of chemicals leads to the symptoms associated with an allergic reaction.

Food Intolerance

Food intolerances can take some time to diagnose. Although not life threatening, food intolerance can and often does, make the sufferer feel extremely unwell and can have a major impact on working and social life. 

There are many possible symptoms that could be caused by having an intolerance to food. Depending on the type of food that is suspected depends on the possible range of symptoms. Symptoms commonly affect the digestive, skin and respiratory systems. With a food tolerance, the person may be able to tolerate a small amount of food before they experience symptoms. 

Common types of food intolerances are lactose intolerance which happens when there are reduced levels of the enzyme lactase in the digestive system needed to break down the ‘sugar’ found in cow’s milk or where, gluten intolerance and certain types of food additives and food chemicals 

A nutritional therapist is a useful resource for those who are concerned over suspected food intolerance or need dietary advice on food avoidance and replacement. 

Differences 

The difference between an allergy and intolerance is how your body responds to foreign triggers. The immune system causes an allergic reaction, while your digestive system, through either a lack of an enzyme required to break down the proteins and peptides or dysbiosis causes an intolerance. 

There are no cures for food intolerances or allergies however a healthcare professional may recommend a management plan to provide symptom relief and prevent a reaction.

With Coeliac disease and wheat allergy, it is crucial that gluten is excluded from the diet for life as this can cause a severe immune response however, a simple gluten intake mistake can trigger symptoms but is unlikely to cause long term gut damage.

Those with NCGS, consumption of gluten will likely trigger symptoms or a flare of symptoms.