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'Gluten-free for me, please': You may well be coeliac, but you should not self-diagnose

Experts have warned that diagnosing coeliac disease can be challenging, requiring a series of tests and procedures.

GLUTEN-FREE IS something that has surfaced over the last few years, with a lot more products hitting the shelves and a lot more people opting for that sort of diet.

However, this week at the annual conference of the Association of European Coeliac Societies (AOECS), professionals warned against those self-diagnosing the disease.

Dr Nicholas Kennedy, President of the Coeliac Society of Ireland said:

Gluten intolerance and the benefits of gluten-free diets have become hot topics in Ireland in recent times.Increasing numbers of people are self-diagnosing wheat or gluten sensitivities, and this can lead to very specific challenges further down the line, when it comes to being tested for coeliac disease.

Eliminating gluten 

However, he warned that eliminating gluten from your diet before testing may result in a false negative result. 

It is important to be on a gluten-containing diet before testing in order to ensure the most accurate result.

Coeliac disease is common and is increasing in prevalence, currently affecting approximately one per cent of the population overall,” said Dr Ciarán P. Kelly MD, Professor of Medicine at Harvard Medical School, Director of Gastroenterology Training and Medical Director of the Coeliac Centre at Beth Israel Deaconess Medical Centre in Boston.

He said there is also increased reporting of non-coeliac gluten sensitivity, but the true prevalence of this condition is unknown.

While a gluten-free diet is the mainstay of therapy for both conditions, differentiating between coeliac disease and non-coeliac gluten sensitivity is important, he said.

Coeliac disease 

He outlined key differences between coeliac disease and non-coeliac gluten sensitivity.

For those with coeliac disease, a gluten-containing diet causes symptoms such as bloating and discomfort, but also intestinal injury, high coeliac antibodies, malabsorption and nutritional deficiencies. 

If untreated, it can lead to complications such as osteoporosis. 

Those with coeliac disease tend to have a genetic predisposition towards the disease. It can be associated with other autoimmune diseases, and the only treatment is a lifelong strict gluten-free diet.

In contrast, those with non-coeliac gluten sensitivity tend to have no known genetic predisposition; no known complications; and the strictness and duration of their gluten-free diet may vary.

“Adopting a gluten-free diet has become increasingly popular. From 2004 to 2014, the market for gluten-free products grew by more than 20 per cent each year.”

Diagnosing coeliac disease can be challenging, requiring a series of tests and procedures. 

Undertaking a gluten challenge is the final step for a patient in being positively diagnosed, he said.

This is why self-diagnosis can be so harmful: if a patient is already following a gluten-free diet when they present to their clinician, it can delay and distort the diagnosis process.

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