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Gluten Intolerant

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Food allergies and food intolerances although very
different, usually, have the same symptoms.
Food allergies not only can make someone feel ill but
also can cause a life-threatening reaction called
anaphylaxis(a serious allergic reaction. It's a medical
emergency. It can be very serious if not treated
Lactose intolerance and coeliac disease can cause
someone to feel ill.
Food intolerance, also known as non-allergic food
hypersensitivity (non-IgE mediated food
hypersensitivity), refers to difficulty in digesting certain
foods. Food intolerance means a particular food might
irritate the digestive system or the body cannot
correctly understand the food you eat, or that symptom
of food intolerance can include nausea, gas, cramps,
abdominal pain, diarrhoea, irritability, nervousness, or
headaches. Many different foods can cause it.
We cannot treat this particular condition.
However, a strict lifetime gluten-free diet is the solution.
Nutritional deficiencies and other complications such
as unexplained infertility issues, osteoporosis and
cancer of the small bowel are the consequences if you
don't follow a gluten-free diet.
A food allergy happens when the body's immune
system, which usually fights infections, sees the food
as an invader; this triggers an allergic reaction, a
response from the immune system in which chemicals
like histamine are released in the body.
The result can cause symptoms like breathing
problems, throat tightness, hoarseness, coughing,
vomiting, abdominal pain, hives, swelling, or a drop in
blood pressure.
See the difference between food Allergy and food
intolerance (Follow the arrow)
My name is James, James Smith! I have a doctor's
appointment today at 10.30am to check my blood tests
results I carried out a week ago. In the waiting room, I
kept wondering when I would be called. 15 minutes
later, I see my name on the screen. Not bad at all, only
15 minutes late!! I walk towards the last door with Dr
Nadeem written on it.....
Good morning Doctor Nadeem!
Hello Mr Smith. How are you?
Well, I am ok. But I am a bit worried why
you needed to see me...What have you found in my
blood tests? Nothing serious I hope...
Well, Mr Smith, according to the symptoms
you gave me, I had asked specific blood tests to be
carried out...
Doctor, I am anxious now...What's wrong
with me?
I am afraid the tests confirmed that you have
coeliac disease.
What is the coeliac disease?
Coeliac disease is an autoimmune condition,
where the body's immune system attacks its tissues
when people eat gluten. It is a common digestive
condition where the small intestine becomes inflamed
and unable to absorb nutrients. It's a genetic condition
and runs in families. It is a myth that you can grow out
of the coeliac disease. Once you are diagnosed, you
have it for life.
Studies have shown that if someone in a family has
the condition, there is a 1 in 10 chance developing the
One in 4 people with coeliac disease has previously
been treated for Irritable Bowel Syndrome (IBS) before
the diagnosis of coeliac disease, so people with IBS
should be tested for coeliac disease.
Dermatitis herpetiformis (DH) is the skin condition of
the coeliac disease. Statistics show Coeliac disease
affects at least 1 in 100 people in the UK; however,
only 1 in 4 individuals with the condition are currently
clinically diagnosed.
What causes it?
Gluten is a protein found in the grains wheat,
rye and barley. Some people with coeliac disease are
also sensitive to oats.
What are the sources of gluten?
Foods that contain traditional flour such as,
bread, cakes, biscuits, cereals and pasta. In many
favourite foods, gluten is present such as stock cubes,
gravies, sauces, soy sauces, fish fingers, sausages,
and even in some chocolate. If someone intolerant to
gluten accidentally eats gluten, they are likely to be
unwell within a few hours.
What are the symptoms?
As I mentioned to you last time I saw you,
there is a range of symptoms including anaemia,
constant mouth ulcers, stomach pain, regular bouts of
diarrhoea, weight loss, crippling fatigue and vomiting
(can last several days). When you eat the offending
food, the symptoms triggered are slower to appear,
often many hours and even the next morning after
ingesting it.
What is the next step?
I am going to refer you to a dietitian. You will
receive an appointment soon. Meanwhile, here are
some guidelines to help you to start off on your life
According to the NHS Choices website, dietitians are
qualified ‘to advise on all aspects of eating and diet;
this includes special diets for medical conditions, such
as a diet for someone who is coeliac disease'.
Only those registered with The British Dietetic
Association (BDA) can be called a dietitian.
Wikipedia defines a dietitian (or dietician) “an expert
in dietetics; that is, human nutrition and the regulation
of diet. A dietitian alters their patient's diet based on
their medical condition and individual
needs. Dietitians are regulated healthcare
professionals licensed to assess, diagnose, and treat
nutritional problems.
Visiting the Dietitian
Today, I have an appointment with a dietitian after
waiting for almost a month. Some friends told me they
expected for at least three months to get one! I'm
meeting Mrs Drinkwater to discuss my food
Good afternoon Mrs Drinkwater.
Good afternoon Mr Smith, how are you
I have mixed feelings; excited to get your
advice about what to eat, what not to eat but at the
same time, it’s life-changing, and it's scary! I have few
questions to ask you about my new “friend”, coeliac
What food contains gluten?
bread, pasta, breakfast cereals, wheat
flour, pastry, pizza bases, cakes, biscuits, seasonings
and spice mixes.
Does alcohol contain gluten?
Some drinks are not suitable for people
with a coeliac disease such as barley squashes, beer,
lager, stout and ales.
Oh my god, I cannot drink beer, it’s a
I understand your disappointment, Mr
Smith. Avoid beer unless it is specially brewed to be
Rum (not dark rum), gin, tequila, and potato vodka are
gluten-free. Champagne, Brandy, cognac, port wine,
vermouth, cider and all wines are safe for coeliacs.
Bourbon, as well as whiskey, are not universally
accepted as gluten-free, so proceed with caution. If you
wish, I can give you a complete list of alcohol gluten
What are the sources of contamination?
It's an excellent question!
Breadcrumbs in toasters, on breadboards, utensils
used for spreading and spooning jam, butter, chutney
etc. onto bread and from cooking oil and water.
Food that contains gluten during preparation can cross-
contaminate gluten-free diet.
Kissing someone who just used gluten filled a lipstick,
or ate gluten, are all additional possible ways to get
cross contaminated.
As I have mentioned previously: lipsticks, lip balm as
well as lotions, toothpaste, makeup, etc. you need to
check all to ensure they don't contain any gluten. It
cannot be absorbed through the skin but has the
potential to get into the air and can be inhaled such as
powder blush, eyeshadow, concealer, etc.
Restaurants: They have a lot going on inside their
kitchen, and in most locations there is a lot of gluten
to be found. So many restaurants are trying to do a
gluten-free menu, but without proper training, you may
very well get contaminated by gluten. That is the risk
we take when we don't prepare our food.
Any useful tips?
Certainly! If you leave alone, use
different coloured stickers to distinguish between
gluten-free and products gluten-containing in the food
cupboards and fridge.
Purchase a sieve in a different colour for gluten-free
foods, so it doesn't get mixed up with the strainer used
for gluten-containing foods.
Buy gluten-free grains that are certified gluten-free to
ensure cross-contamination didn’t take place during
Read labels carefully to be sure you’re avoiding
wheat, but also other gluten grains like these.
Anything else can I do for you, Mr
Smith? Before you go, I would recommend having a
look on as there
are regular updates on coeliac disease and the ways
keeping healthy.
Thank you very much, Mrs Drinkwater, for
your advice.
Goodbye Mr Smith!
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