Coeliac disease (also spelled celiac) is an autoimmune condition that causes the immune system to react abnormally to gluten - a protein found in wheat, spelt, rye, barley and oats, resulting in damage to the villi (small finger-like projections) of the intestinal lining. This damage called villous atrophy can result in reduced nutrient absorption, increased inflammation, intestinal permeability and potential for a wide range of complications even after gluten consumption has ceased. While going gluten-free may help people with a range of digestive symptoms, there is no coeliac disease treatment, and a 100% gluten-free diet is required for life.
Outside of going gluten-free, there are many measures people with coeliac disease can take to improve their gut health, digestion, and overall wellbeing to reduce the risk factors and complications associated with the condition.
At Melbourne Functional Medicine, our practitioners use a natural treatment approach to support people with coeliac disease, providing information and protocols for a healthier and happier gluten-free life.
Unlike a food allergy, coeliac disease occurs in genetically susceptible individuals and is called gluten triggered T-cell mediated autoimmune enteropathy. It is more severe than gluten intolerance, non-coeliac gluten sensitivity (NCGS) or non-gluten wheat sensitivity (NCWS), with more serious and ongoing side effects/health consequences.
Up to 50% of people with coeliac disease are asymptomatic, meaning that coeliac disease is vastly under-diagnosed, and symptoms can vary considerably between individuals. This is very concerning for those who can’t tell when they’ve been exposed to gluten. Currently, around 80% of Australians with the condition don’t know they have coeliac disease, and some wait more than 11 years before receiving an accurate diagnosis.
Common signs and symptoms people with undiagnosed or unmanaged coeliac disease may experience include:
Digestive
Skin
Brain/cognitive
Other
People with coeliac disease are also more likely to develop a myriad of other health complications, even after removing gluten from the diet, including:
While there is no coeliac disease treatment, taking a proactive approach with holistic support for people with coeliac disease can help improve overall health and prevent further health complications associated with the disease.
Research has found people with the ‘atopic triad’ have a defective barrier of the skin and upper and lower respiratory tracts.
These genetic alterations cause a loss of function of filaggrin (filament aggregating protein), which is a protein in the skin that normally breaks down to create natural moisturisation and protect the skin from penetration by pathogens and allergens.
Filaggrin mutations are found in approximately 30 percent of people with atopic dermatitis, and also predispose people to asthma, allergic rhinitis (hayfever), keratosis pilaris (dry rough patches and bumps on the skin), and ichthyosis vulgaris (a chronic condition which causes thick, dry, scaly skin.)If one parent carries this genetic alteration, there is a 50 percent chance their child will develop atopic symptoms. And that risk increases to 80 percent if both parents are affected.
Food hypersensitivity has been found to cause or exacerbate atopic dermatitis in 10-30% of cases, and 90% of these are caused by eggs, milk, peanuts, soy and wheat.
The connection between the gut microbiome and skin health is complex, however, research has found the microbiota contributes to the development, persistence, and severity of atopic dermatitis through immunologic, metabolic and neuroendocrine pathways.
Deficiency of Omega-6 essential fatty acids (EFA) has been linked with the increased incidence of atopic dermatitis, along with the inability for the body to efficiently metabolise EFA’s to gamma linoleic acids (GLA) and arachidonic acids (AA).
Changing weather conditions can certainly aggravate eczema symptoms, but the triggers are subject to change among individuals.
Mould exposure and susceptibility to mould can cause Chronic Inflammatory Response Syndrome (CIRS), of which dermatitis is a manifestation.
Coeliac disease root causes and contributing factors are still being researched, with a growing number of proven links and evidence mounting for others. So it’s likely there is no one single root cause of coeliac disease, but perhaps a combination of factors that lead to the development of coeliac disease including:
Family history: Genetic predisposition is a strong factor in the onset of coeliac disease.
The prevalence of coeliac disease among first-degree relatives is five times higher than in the general population, while there is a 70% concordance between identical twins. Coeliac disease can develop at any stage of life and affects women twice as often as men.
Viral infection: Studies have found evidence of increased incidence of coeliac disease following gastrointestinal viral infections such as rotavirus.
Microbiome dysbiosis: Research suggests a higher incidence of coeliac disease among people with intestinal dysbiosis, including children exposed to systemic antibiotics in the first year of life, those born by c-section, and children not being breastfed at the time gluten is introduced to the diet.
The current recommended diagnostic test for coeliac disease is an intestinal biopsy to identify villous atrophy. Blood tests are also commonly used to test for IgA and IgG antibodies in the blood. Both tests require ongoing consumption of gluten at the time of testing to obtain an accurate result, which is why Coeliac Australia recommends people continue to eat gluten until diagnosis confirmation. Gene testing for the GLA gene can also be used and doesn’t require current gluten consumption, however, the presence of the gene only indicates a genetic predisposition, and doesn’t confirm coeliac disease or guarantee the condition will develop.
Once a diagnosis is made, you may be referred to a gastroenterologist for further investigation to explore if there is damage to the lining of the intestinal tract.
Unfortunately, there is no treatment for coeliac disease, so those who are diagnosed with the condition are advised to avoid the consumption of gluten for life.
In addition to conventional testing, there is a range of functional tests that will help identify the root causes and triggers of coeliac disease and help avoid other symptoms developing. They may include:
Our functional medicine naturopaths regularly support people with coeliac disease or gluten intolerance, and those who just suspect it. They will take a deeper look at the state of your overall health and wellbeing, supporting your recovery from the damage caused by coeliac disease. Coeliac disease support commonly includes:
Investigating other reactive foods: People with coeliac disease and NGCS have higher rates of allergies, sensitivities and other autoimmune disorders, including lactose intolerance. Our practitioners will use allergy testing to determine any other foods you may need to remove from your diet.
Restoring gut function and immune health: A tailored gut repair protocol, often including a mix of soothing herbal medicines and probiotics is part of a natural treatment approach. A 2019 study found the use of specific probiotic strains Lactobacillus plantarum HEAL9 and L. paracasei 8700:2 positively influenced the levels of specific immune cells involved in coeliac disease. While glutamine, slippery elm, goldenseal, licorice and aloe vera can all promote gut repair and protection of the intestinal lining, herbs like echinacea, baical skullcap, alfalfa and nettles can all aid immune support and nutritional status.
Addressing nutritional deficiencies: People with coeliac disease are prone to deficiencies of vitamins and minerals due to poor absorption, particularly deficiencies in iron, Vitamin B12, calcium, vitamin D and other minerals. Our practitioners will guide you on foods to avoid if you have coeliac disease, and may recommend pathology testing to regularly assess nutrient levels. They create personalised nutritional protocols tailored to your individual dietary needs.
Personalised ongoing dietary and health support: Coeliac disease is a life-long autoimmune condition, but with the right support, people with coeliac disease can live long healthy lives. Autoimmune disorders can flare at any time, causing a resurgence of symptoms, particularly after stressful events, pregnancy or childbirth. Our practitioners and health coaches will continue to work with you through every stage of your journey with coeliac disease, to support you and your family with living a healthy and fulfilling gluten-free life.
Together with our functional medicine practitioners, our health coaches will provide the support you need to be successful in achieving your health goals.
Are you ready for a personalised, natural functional medicine treatment? Our unique model of care was designed with you in mind. Find out how below, then book a call today!
Yes, the immune system of people with coeliac disease mistakenly reacts to gluten in the small intestines causing the tiny, finger-like projections called villi, to flatten and become inflamed. This is called villous atrophy and reduces the ability to absorb nutrients, leading to malnutrition and digestive symptoms. If not diagnosed or treated, several serious health conditions can develop.
Genes associated with coeliac predisposition are HLA DQ2, HLA DQ8, and can be determined by a blood test. A genetic predisposition is associated with celiac disease, however, it does not guarantee you will develop it. Either one or both of these genes is present in 50% of the population; however, approximately only 2.5% of these people will be diagnosed.
Due to damage to the small intestines where most nutrients are absorbed, many people experience weight loss, however, a small percentage will experience metabolic disturbances and weight gain. Other metabolic conditions such as type 2 diabetes and non-alcoholic fatty liver disease are also associated with coeliac disease.
Coeliac disease is an autoimmune condition affecting the lining of the small intestines due to a reaction of the immune system in the presence of gluten.
Gluten intolerance (also called non-coeliac gluten sensitivity, and non-coeliac wheat sensitivity) are conditions where a similar range of gastrointestinal symptoms can be experienced although without damage to the villi called villous atrophy.
In gluten intolerance, symptoms subside once gluten is removed, whereas in coeliac disease consequences of this damage can continue long after the exclusion of gluten.
Sadly, around 80% of people with coeliac disease are undiagnosed, some without any symptoms. Coeliac disease can develop at any stage of life. Most people feel unwell after consuming gluten-containing foods, however, some may have no symptoms at all.
Common symptoms are;
Accidental exposure to gluten to those with coeliac disease is commonly referred to as being ‘glutened’, often (but not always) resulting in a painful acute episode of extensive bloating, abdominal pain and cramping, brain fog, headache, vomiting, diarrhoea and constipation. The onset of symptoms usually occurs within 1-2 hours of consumption, with symptoms lingering for hours, days or even weeks. However, the intestinal damage caused by exposure is a long-term complication, which is particularly problematic if you do not have/have minimal symptoms and remain unaware of this damage.
Whether you have a diagnosis or just suspect it, if you’d like to know what to eat, or which foods to avoid if you have coeliac disease, our functional medicine practitioners can help you live a long and healthy gluten-free life.
While a gluten-free diet is necessary for coeliac disease patients, cutting out other nutrients can result in greater nutrient deficiencies. While the keto diet can be beneficial in certain circumstances, it is not for everyone. Always be guided by experts for your coeliac natural treatment plan including dietary recommendations. Our practitioners can provide you with a coeliac disease diet plan that will provide nutrient-dense, optimal support for your intestinal microbiome and overall health.
If you’d like support with a functional medicine approach to managing coeliac disease, book a free discovery call today.
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