Coeliac disease: when gluten causes problems in the gut

What is coeliac disease?

Grains such as wheat, rye and spelt naturally contain the glue protein gluten. In people with coeliac disease, gluten damages the mucous membrane of the small intestine because the villi of the small intestine are destroyed, thus reducing the surface area of the intestine. This damage makes it harder for the intestine to absorb nutrients. The result can be deficiency symptoms such as calcium deficiency – one late effect is osteoporosis, for example.

What is gluten?

Gluten is a protein, also called glue protein, which is found in various types of cereals. It’s found naturally in wheat, rye, barley and spelt, but also in many processed foods as an additive. Those with the condition can be guided by the official gluten-free symbol, the slashed ear of corn.

Cause of coeliac disease

Across Switzerland, an estimated 1% of the population is affected by gluten intolerance. The condition is clearly distinguishable from gluten sensitivity and wheat allergy, a classic food allergy. This is because there are no antibodies and the small intestinal changes typical of coeliac disease aren't present in this case. Despite intensive research, the cause is still not one hundred percent clear. Genetic predispositions or infections rank high on the list of possible triggers. In addition, a disease rarely comes alone – it occurs in conjunction with diabetes type 1, for example, or autoimmune diseases of the thyroid gland and the skin.

Coeliac disease symptoms & complaints

As is often the case, the symptoms are varied and don't automatically manifest themselves in digestive problems. Children and adults exhibit different symptoms:

Diagnosing gluten intolerance

If coeliac disease is suspected, the gastroenterologist will take blood samples and look for coeliac antibodies in the blood. To assure a correct diagnosis, they will also carry out an inspection of the small intestine and take tissue samples. It’s important to know that anyone who eats a gluten-free diet in advance makes the diagnosis more difficult. In other words: first wait for the diagnosis and then start treatment.

Late effects if coeliac disease isn't treated

Late effects of untreated coeliac disease can include osteoporosis, anaemia due to permanent deficiency symptoms or small intestinal lymphoma due to changes in the villi.

The solution: gluten-free diet

Coeliac disease can't be cured, but it can be effectively treated by switching to a lifelong gluten-free diet. The mucous membrane of the small intestine usually recovers quickly and symptoms decrease. Even if you’re free of symptoms, it’s advisable to go for a check-up at least once a year to clarify possible deficiency symptoms and check your current diet.

Gluten isn't only found in cereals, but is also hidden as emulsifiers, flavourings and binders in processed foods such as spices, crisps and sausages. The general advice is to study ingredient lists for wheat starch, barley malt extract or malt and look for the gluten-free symbol!

Gluten-free foods

The easiest way to follow a gluten-free diet is to stick to natural and gluten-free foods. A gluten-free diet is neither one-sided nor bland. People with the condition can eat all forms of fruit and vegetables, natural meat and fish, nuts, dairy products, pulses and carbohydrates such as potatoes, quinoa, corn, rice and millet. In addition, the selection of gluten-free products like flour and other substitute products has increased enormously in recent years.

Even small amounts can trigger complaints

50mg of gluten, i.e. a small crouton in a salad, can already be enough to trigger symptoms in those with the condition. It’s therefore important to protect yourself from contamination, even at home. Follow these simple tricks to ensure a gluten-free diet.

• Store gluten-free food and food containing gluten separately from each other
• Clean work surfaces, pots and kitchen utensils regularly
• Buy kitchen appliances, such as a toaster, twice over
  

Recipe for gluten-free buckwheat crepes

Ingredients for 2 persons

Pancakes

50g buckwheat flour
50g chickpea flour
1/2 tsp. salt
150ml milk
150ml water
1 egg
1/4 tsp. gluten-free baking powder
1/4 bunch parsley, chopped

Sauce and salad

3 tbsp. olive oil
1 onion, finely chopped
2 sprigs rosemary
1 garlic clove, crushed
300g mushrooms, quartered
salt and pepper
1 tbsp. cashew butter
approx. 100ml water
1 bag baby spinach
1 tbsp. balsamico vinegar
2 tbsp. sunflower seeds

Method

1. Put all the ingredients for the pancake batter in a blender and mix.
   
2. Cover the batter and let it rest for about 10-15 minutes.
   
3. Meanwhile, prepare the mushroom filling. Heat 1 tbsp. olive oil and sauté the onion in it. Add the rosemary, garlic and mushrooms. Sauté until the mushrooms are soft. Don't stir them too often. The mushrooms should be allowed to brown a little. Finally, season with salt and pepper and add the cashew butter and water.
   
4. Fry the pancakes in olive oil on a medium heat until golden brown.
   
5. Serve the pancakes with the sauce and a simple spinach salad. Season the spinach with olive oil, balsamic vinegar and salt. Sprinkle with sunflower seeds and serve.
   

Further information and help