Anyone who has worked in the catering industry, or indeed been to a restaurant in recent times, will probably have heard the phrase, “Do you have any gluten-free food available?” This is usually followed by the waiter trying their best to accommodate the restaurant patron, and the chef going off menu to include ingredients which wouldn’t traditionally be in the dishes the kitchen would prepare.
What some may not know as they scoff at what might on its surface seem like a pretentious trend, is that some individuals are genuinely incapable of ingesting gluten without having adverse effects.
Celiac disease is an autoimmune disorder that can occur in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine. It is estimated to affect 1-2% (1-2 in 100 people) of the European population, although it is estimated that many sufferers are still undiagnosed.
Celiac disease is also a hereditary (it runs in the family), and research has indicated that a close relative like a parent, child, or sibling have a one in 10 chance of developing it.
Eating foods or ingesting medicine that contains gluten can activate the disease, and if left untreated can lead to multiple health issues piling on top of the initial diagnosis. Other autoimmune disorders that are known to come out of untreated celiac disease include Type 1 diabetes, multiple sclerosis, infertility and miscarriage, intestinal cancers, and neurological conditions like epilepsy and migraines.
According to the World Gastroenterology Organisation, celiac disease may be divided into two versions of itself – classical and non-classical.
Patients of the ‘classical’ version have signs and symptoms of malabsorption, including diarrhoea, steatorrhea, and weight loss or growth failure in children.
Whilst patients of the ‘non-classical’ are more likely to suffer from symptoms such as chronic fatigue, chronic migraine, peripheral neuropathy, and reduced bone mass and bone fractures.
Visible symptoms vary depending on if the patient is a child or an adult, and there are more than 200 known symptoms which may occur in the digestive system or other parts of the body. Also, the reasons why celiac disease develops at different ages for different people is still unknown.
Children are more likely to exhibit symptoms such as chronic diarrhoea, vomiting, weight-loss, and Attention Deficit Hyperactivity Disorder (ADHD), whilst adults are more likely to endure fatigue, bone or joint pain, depression or anxiety, and peripheral neuropathy.
The only treatment currently available is a strict gluten-free diet which must be followed for the rest of the sufferer’s life. This diet involves the removal of wheat, rye and barley as ingredients from the range of food selection. This includes bread and beer, two items that one might call “imperative” to the Maltese diet.