Dr Peter Moore: Coeliac disease is easy to treat
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We’re now into the Torquay United pre-season friendlies. Every year I say to myself ‘this year we will win the league and get promoted’.
Of course, as a Torquay supporter I am, just occasionally, disappointed but it doesn’t stop my annual optimism.
Among the new signings is Danny Wright. But he has another story covered in the Torbay Weekly.
When he met his wife she told him she had coeliac disease. The more she described her symptoms the more he recognised them. He was tested and found that he had it as well.
Some types of wheat, especially barley and rye, contain a protein called gluten. For most of us, gluten is a healthy part of our diet but for anyone with coeliac, it causes a reaction in the gut. Antibodies are released which attack the small bowel where most of our food in absorbed.
But, as Danny Wright found, symptoms are vague. It often takes a long time to diagnose.
One in five patients are not diagnosed until they are over 60, even too old to play for Torquay United. It has been estimated that eight out of ten are never diagnosed.
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Sufferers can lose weight, have loose motions and just feel tired. They may become anaemic. Vitamins A, D, E and K are poorly absorbed along with calcium leading to thin bones or osteoporosis. Many people do not even realise that they are ill until they are given a gluten-free diet and suddenly feel much better.
Children can suffer from ‘failure to thrive’ which does exactly what is says on the tin.
It can be diagnosed with a blood test but, like many other tests, it can give a false negative.
The most accurate, but more invasive, test involves taking a sample of the lining of the gut.
In coeliac disease the lining, which is usually up and down like the Devon countryside, becomes flattened, more like the Fens.
But all tests are likely to be negative if the person has already started a gluten-free diet.
I recently saw a notice in a shop warning people that the gluten free food might contain ‘traces of gluten’. I was tempted to add ‘don’t worry; traces are not a problem for anyone with coeliac disease’.
It is not like nut allergy. For someone with a severe nut allergy any exposure to nuts can cause a serious reaction. Coeliac disease is a food intolerance. A tiny trace of gluten will not be a problem.
One study suggested that up to 10gms of gluten a day is safe but the exact amount is not clear.
We know that it is a genetic disease, it runs in families. Families with coeliac are also more likely to have other autoimmune diseases such as thyroid problems or type 1 diabetes.
The disease was first described in 1887 by Dr Gee, a paediatrician and Greek scholar. He thought the disease he saw in a child at Great Ormond Street Hospital was similar to a case described in ancient Greek literature, not something many 21st century doctors would notice. He also realised it was due to diet so fed a child on ‘a quart of the best Dutch mussels’. This helped but, not surprisingly, was not well tolerated.
The breakthrough came in the Netherlands in 1944.
As the Nazis were losing the war, they cut off food and fuel to the farms leading to a shortage of flour and bread.
Many people starved but a paediatrician, Dr Dicke, noticed that children with coeliac disease improved. Once the war was over they deteriorated again.
He realised that wheat was causing the problem and, in 1952, a team from Birmingham discovered the link with gluten.
Coeliac disease is easy to treat, just avoid gluten, but it is inconvenient.
Danny Wright cannot have the usual pre-match pasta or even sandwiches but let’s hope he can have a feast of goals.