One in every hundred Australians are affected by Coeliac disease, but 75 per cent are undiagnosed, meaning that about 160,000 Australians have coeliac disease but don’t yet know it.
Gluten is a protein found in wheat, rye, barley and outs, which causes small bowel damage in people with coeliac disease when consumed.
They experience what is referred to as villous atrophy, where the tiny, finger-like projections which line the bowel become inflamed and flattened and the surface area of the bowel available for nutrient absorption is markedly reduced, causing various gastrointestinal and malabsorptive symptoms, according to Coelic Australia.
There are a number of serious health consequences can result if the condition is not diagnosed and treated properly.
How is coeliac disease different to gluten intolerance?
People are born with the genetic predisposition to develop coeliac disease but environmental factors play an important role in triggering coeliac disease in infancy, childhood or later in life.
“We know one per cent of the population has coeliac disease, but the issue is that only 25 per cent of them are diagnosed at the moment,” Penny Dellsperger, Accredited practicing Dietician told Food Magazine.
“I think there are better ways to diagnose, and it’s being picked up on because of the increased awareness, so it’s difficult to know if the rates are actually rising, or if we’re just better at picking up on it now.
“In terms of how quickly it is rising, we believe one in 100 Australians has coeliac disease at the moment, but it could be more than that,
“In terms of gluten intolerance, there is not enough evidence out there to know how many people have that.
“I did hear a figure quoted recently that about 10 per cent of the population is on some sort of gluten restriction, but I don’t know if that is right or necessary.
“It might just be a bit of a fad, and it is a bit of a double-edged sword, because for those who do suffer from coeliac disease it’s good because there is more gluten free food available and having that awareness is good, but on the other end of the sword they may be down-playing the real implications of having coeliac disease.”
Part of the reason for the number of undiagnosed cases of celiac disease is the varied symptoms that come with the condition.
Some people suffer severe symptoms, while others are symptom free and there is also a lot of confusion about coeliac disease and gluten intolerances, as Dellsperger told Food Magazine.
“Obviously ceoliac disease is quite different to being gluten intolerant, there are specific medical tests to diagnose and manage celiac disease and we know exactly how to manage it, whereas gluten intolerance is not well decide and it hasn’t even been officially decided if there is a separate gluten intolerance to ceoliac disease,” she explained.
“If it does turn out that there is a separate condition, that will have implications on how it is dealt with, because at the moment there is no valid test and there is not any damage long term as there is for is no long term damage like there is with coeliac disease.
“Because of that, the actual management could be quite different, with coeliac disease we know people must follow a strict gluten-free diet for their entire lives, whereas with gluten intolerance, as long as the person is feeling fine, then they are fine.
“There certainly is research going into gluten intolerance or sensitivities and hopefully there will be developments on that.
The warning signs
Coeliac Australia says if a person is suffering more than one of the high risk factors, they should not be ignored.
The high risk conditions include Iron Deficiency, Anaemia and other Vitamin and Mineral Deficiencies, Autoimmune Disease, Weight Loss, Infertility and Gastrointestinal Symptoms.
Those with a family history of the disease should also get tested, as it is a genetic condition.
Other less common symptoms, which are often thought to be unrelated, but could point towards a gluten intolerance include altered mental alertness and irritability, bone and joint pains, fatigue, weakness and lethargy, easy bruising of the skin, recurrent mouth ulcers and/or swelling of mouth or tongue and skin rashes such as dermatitis herpetiformis.
In children, failure to thrive or grow normally can be indications of celiac disease.
There is no cure for the condition, and those who suffer from ceoliac disease are sensitive to gluten throughout their lives.
But as the rates of coeliacs rises, so too is the number of gluten-free options available.
As long as the gluten free diet is strictly adhered to, problems arising from coeliac disease should not return.
Advancements in food testing
If a person with celiac disease consumes gluten, they may not suffer any symptoms, but they will do damage to the small bowel.
This is why the testing capabilities for gluten are continually undergoing improvements, as the impacts of coeliacs consuming gluten become more apparent.
Andrew Odd from Australasian Medical and Scientific Ltd told Food Magazine the improved testing capabilities for gluten “has been a long while coming but finally getting there.”
He said the two new gluten testing kits launched by Romer Labs make it simpler and more accurate for manufacturers to ensure there are no traces of gluten in its products.
The AgraStrip Gluten G12 is a lateral flow device for onsite factory testing and the AgraQuant Gluten G12 is an ELISA for quantitative testing in the laboratory.
The brand-new test kits use Romer Labs proprietary gluten detection technology, which employs a next generation antibody, called G12.
“Essentially, it is a colour-change device which can be used on surfaces for environmental monitoring purposes or areas or materials with cross-contamination issues with batches of products, it and can also be used in testing raw materials and finished products,” Odd explained.
“There are some very basic tests involved, but at the end you’ve got a strip which has come colour lines appear which give a visual indication of whether a sample was positive of negative for a particular allergen, in this case gluten.”
He said the new technology affords food manufacturers peace of mind and quality assurance.
“For starters it gives them good confidence in the products they’re manufacturing and they don’t have to run the risk of undeclared allergens being present in products and having to possibly recall a batch,” he told Food Magazine.
“It gives greater control over quality-control programs and allows action to be taken immediately, in real time, because they don’t have to wait for it to be sent to laboratories.”
“The sensitivity levels are very high.
“It detects down as low as five parts per million and currently, there is a lot of international consensus that 20 parts per million and above is considered a problem, so it can beat that level.
“But the levels can also be customised so it isn’t too sensitive.
“Previously the tests to do this sort of analysis were really only available to laboratories, but these strips are making it a lot easier for manufacturers to do the testing on-site, and they don’t need any equipment to run them.”
Children with undiagnosed coeliac disease can suffer lack of proper development, short stature and behavioural problems.
Coeliac Australia works to raise money and find better treatment for children with the condition, by studying the immune responses to gluten in children and working towards new treatments, including a coeliac vaccine.
They also aim to establish effective treatments to prevent or control the acute “food poisoning” that can be experienced in coeliac disease following accidental gluten consumption and develop a diagnostic test for coeliac disease that is effective in people already gluten free without requiring a prolonged gluten challenge and potentially avoid the need for an intestinal biopsy altogether.