Coeliac disease

Coeliac disease is an abnormal immune response to ingested gluten. Normally, our immune system functions to protect us from disease by producing antibodies against foreign, harmful microorganisms and other microscopic particles. In coeliac disease, the body’s immune system mistakenly identifies as harmful the enzyme that helps to break down gluten, and produces antibodies against it. This leads to inflammation of the small intestine lining, which decreases the amount of nutrients absorbed by the body. Without absorbing all the nutrients that the body needs, other problems may also develop, for example, osteoporosis(from a lack of calcium).

The inflammation of the small intestine lining also leads to undigested food passing through to the large bowel. In some people, this causes gastrointestinal symptoms such as bloating, cramping and diarrhoea. However, it is important to note that there is no relationship between the severity of the symptoms and the damage being done to the lining of the small intestine. So, someone with little or no symptoms may have significant damage to their small intestine lining. For this reason, it is crucial that coeliacs do not ingest any gluten.

Gluten intolerance

In contrast, gluten or intolerance is a digestive system response to gluten, rather than an immune response. Generally, the severity of the symptoms is proportional to the amount ingested. Symptoms of gluten intolerance include nausea, stomach cramps, heartburn or reflux, diarrhoea, and bloating.

For example, individuals who suffer from gluten intolerance will suffer more severe symptoms when ingesting larger amounts of food containing gluten. If they eat only a tiny amount, they may not suffer any symptoms.

Conclusion

So, regardless of the severity of symptoms experienced, someone who has Coeliac disease should not ingest gluten, as unseen damage may occur to the small intestine lining.

Someone who has an intolerance to gluten, may be able to tolerate small amounts of gluten, depending on the severity of their gastrointestinal symptoms, without any significant internal damage. Over time, they may be able to work out how much their body can cope without symptoms.

References

http://food-allergies.suite101.com/article.cfm/food_allergies_vs_food_intolerance
http://en.wikipedia.org/wiki/Coeliac_disease
http://en.wikipedia.org/wiki/Food_intolerance

Most importantly, gluten is in all foods and products containing wheat, barley, rye or oats, so these foods need to be avoided. This obviously means the standard products made from wheat flour such as breads, pastas, biscuits. Note, there are many gluten free substitutes for these foods.
However, gluten may also be contained in foods that you may not expect, such as some brands of corn flour. In order to determine if a product contains gluten, you need to read the ingredients list. It is mandatory in Australia for ingredients containing gluten and other allergens to be specified. The main things to remember when reading labels and ingredient lists are:

• If a product is labelled “gluten free”, this claim overrides the ingredient list and you can be sure that it is gluten free
• If the ingredient list contains any mention of wheat, barley, rye or oats, this food contains gluten. This includes ingredients such as wheat starch, wheaten flour and those with wheat in brackets, eg. maltodextrin (wheat)
• The exception to rule above is that the ingredient “wheat glucose syrup” is OK as it has been so highly processed that it has no detectable gluten
• Malt products like milo, some mayonnaises or malt vinegar, contain barley and therefore, gluten

When in doubt, leave it out.