Registered dietitian Norma McGough is head of diet for the charity Coeliac UK. We asked her what questions she would ask her doctor if she was diagnosed with coeliac disease
I know I have to give up gluten, but are oats safe?
Pure oats are considered to be less toxic than wheat, rye and barley, and they are included in the gluten-free diet of a lot of people with coeliac disease. However, one in 20 coeliacs may be sensitive to pure oats. One of the issues with oats is that because of the way cereals are processed, a lot of oats are contaminated with wheat flour and are not therefore suitable for a gluten-free diet. Speak to your doctor and dietitian about your particular tolerance levels if you would like to include a small portion of oats in your diet.
How soon after going gluten-free will I start to feel better?
Most people feel better within a week or two of eliminating gluten from their diet, but it does vary. If you’ve had many symptoms, you should notice the difference very soon. If routine screening has picked up your coeliac disease, you may not feel very different. Most people notice quite quickly that their gut symptoms are relieved and that they're less tired.
Will I need to take any supplements?
Yes, this might be necessary because many coeliacs have been poorly absorbing nutrients for many years, and may be deficient in several minerals and vitamins. If you're anaemic you may need iron or vitamin B12 and folic acid supplements. Your doctor will advise on the best course of action based on your individual circumstances.
Will I need further tests?
Your doctor may advise further blood tests to check that your iron levels have improved if you were anaemic. Further biopsies may be recommended to check that your gut is healing well on your gluten-free diet. Your doctor may also suggest you're tested for other autoimmune diseases, such as type 1 diabetes, thyroid disease and certain liver diseases, as there is a link between them and coeliac disease.
Will I need to take any medication?
The treatment for coeliac disease is the gluten-free diet. However, if you're suffering from another autoimmune disease, you may need to take medication for it.
Can I still drink alcohol?
Yes, you can drink cider, wine, sherry, port, liqueurs and spirits. You cannot drink beers, lagers, stouts and ales, although some manufacturers are now producing gluten-free beers. We advise that you only drink within recommended safe guidelines.
Am I at greater risk of other diseases in later life?
There is an increased risk of cancer of the small bowel when you're undiagnosed and in the early years after diagnosis, but after you've been on the gluten-free diet for at least five years, your risks of malignancy normalise. There can be an association between coeliac disease and other inflammatory bowel disorders, such as Crohn’s disease and ulcerative colitis. However, the biggest problem associated with people being diagnosed later in life is osteoporosis. This is due to chronic malabsorption of calcium throughout life. Your doctor may recommend you have a DEXA scan to check your bone density at diagnosis, and calcium supplements may be advised.
Are my children at risk of coeliac disease?
If you have coeliac disease, the risk of one of your children having it is about one in 10. If your children are experiencing any symptoms and you have coeliac disease yourself, get them checked. The symptoms in children can be similar to those in adults, but there may also be a failure to thrive or slower growth.
