Coeliac Disease / Non-Coeliac Gluten Sensitivity
What is Coeliac Disease?
Coeliac disease is described by Coeliac Society of Ireland as an autoimmune condition in which the immune system mistakenly attacks its own tissues, resulting in damage to the small intestine. In an attempt to combat enemy (gluten) it ended wounding the gut villi responsible for the absorption of nutrients - because of that, people with coeliac disease that do not follow a gluten-free diet have lack of vitamins and can have a number of other serious diseases due to this condiction. Coeliac disease has some features of a true food allergy because it involves the immune system. However, people with coeliac disease are not at risk of anaphylaxis and the symptoms are most related to gastrointestinal issues as a chronic digestive condition. They vary person to person and can include diarrhoea, constipation, weight loss, chronic tiredness, anaemia, failure to thrive in children, chronic mouth ulcers, stomach pain and bloating, indigestion, bone pain, moodiness or depression, infertility, recurrent miscarriages, flatulence, nausea, vomiting, migraine and Irritable Bowel Syndrome (IBS). Coeliacs following the gluten-free diet must avoid wheat, barley, rye and, in some countries, even oats because of cross-contamination. Any other food that may had have croos-contact with gluten must be avoided.
What is Non-Coeliac Gluten Sensitivity?
According to the Oslo definitions, a consensus document published in 2012 by a group of coeliac disease experts from around the world, Non-Coeliac Gluten Sensitivity (NCGS) is a condition that occurs in individuals who are unable to tolerate gluten and experience symptoms similar to those associated with coeliac disease. Diagnostic tests for coeliac disease or food allergies are negative in such individuals. It may also be referred to as "gluten sensitivity". It is unclear at this time what components of grains trigger symptoms in individuals with NCGS and whether some populations of NCGS patients have subtle small intestinal morphological changes. While there currently is no standard diagnostic approach to NCGS, systematic evaluation should be conducted including exclusion of Coeliac Disease and other inflammatory disorders.
Gluten is made of two proteins: gliadin (a prolamin protein) and glutenin (a glutelin protein). Gluten helps foods maintain their shape, acting as a glue that holds food together because its capacity to stretch and rise due to the action of baking powder or yeast. When wheat flour is mixed with water, the gluten swells to form a continuous network of fine strands - when we put the bread in the oven, the gluten strands coagulate or solidify much as the protein in eggs solidifies as the egg cooks. Gluten can be found in many different kind of food that does not look like contain gluten and it also can be a risk for coeliacs because of cross-contamination. Gluten is commonly found in: breads, baked goods, beer, soups, pasta, cereals, sauces, salad dressings, roux, malt, food coloring, malt vinegar.