Gluten intolerance (also known as coeliac disease) is an autoimmune reaction to gluten, a constituent of various cereal grains.
In Switzerland roughly one per cent of the population suffers from coeliac disease. In people with coeliac disease, gluten (binder protein in different types of grains) causes damage to the mucosal lining of the small intestine. A symptom-free life is usually possible if a gluten-free diet is followed.
People with coeliac disease have a genetic predisposition. As a result, consumption of gluten results in damage to the mucosa of the small intestine. Gluten is a collective term for binder proteins found in different types of grain (wheat, spelt, rye, barley, oats, emmer, unripe spelt, kamut, einkorn and triticale). The damage leads to the breakdown of villi lining the small intestine, thereby reducing the surface area of the intestine. This means that nutrients (carbohydrates, fats, proteins, vitamins and minerals) may be absorbed less effectively and sufficient quantities of these nutrients are no longer available to the body. During the course of the disease, these nutrient deficits can cause deficiency symptoms (e.g. iron deficiency) and relevant consequences (e.g. anaemia).
The symptoms of coeliac disease are characterised by their diversity and varying degree of severity. There are also some forms of coeliac disease in which few, if any, noticeable symptoms occur.
Common symptoms in infants
Weight loss, loss of appetite, diarrhoea, bloating, arrested growth, delayed development, being prone to crying and irritability.
Common symptoms in young people and adults
Fatigue/exhaustion, anaemia, iron deficiency and other states of deficiency, diarrhoea or constipation, recurring abdominal pains, bone pains, loss of weight and strength, reduced physical capacity, concentration difficulties, depressive moods, infertility and premature births in women.
If coeliac disease is suspected, the specific coeliac antibodies are measured in the blood (anti-tissue transglutaminase IgA and IgG, anti-endomysial IgA and IgG and anti-gliadin IgA and anti-gliadin IgG). Another diagnostic test is usually an endoscopy of the small intestine during which a tissue sample is taken (biopsy).
The level of coeliac-specific antibodies in the blood is diet-dependent and decreases if a gluten-free diet is maintained. This is why it is important not to start a gluten-free diet until the diagnosis has been confirmed. Otherwise, it would be difficult or impossible to establish the diagnosis.
Coeliac disease frequently occurs alongside other diseases, for example: type 1 diabetes, rheumatoid arthritis, trisomy 21. Sufferers may additionally develop lactose intolerance or osteoporosis if their coeliac disease has not been detected (for a prolonged period).
Treatment / Therapy
The only known treatment for coeliac disease is a life-long, gluten-free diet. Coeliac sufferers can usually lead a symptom-free, healthy life if they avoid gluten.
Therefore the following points apply to coeliac sufferers:
- They should strictly avoid: wheat, rye, barley, spelt, kamut, unripe spelt, emmer, triticale, einkorn and all foods produced from them (e.g. bread, bakery products, pasta, sauces thickened with flour, etc.).
- Gluten-free oats (uncontaminated with wheat, rye, barley or spelt) are permissible in small quantities for most sufferers. The attending GP or gastrointestinal specialist can provide information on this point.
- The following are gluten-free: sources of carbohydrate that are naturally gluten-free, such as potatoes, maize, rice, buckwheat, quinoa, amaranth, millet, teff flour and pulses. Unprocessed foods such as meat, fish, eggs, milk and dairy products, vegetables, fruit, vegetable oils and sugar are also suitable.
- In the case of ready foods it is important to read the declaration to find out whether or not a product is suitable for coeliac sufferers.
- A wide range of gluten-free specialist foods are available on the market. Sufferers can be guided by the Allergy Seal of Quality (recommended by aha!) and the gluten-free symbol (crossed-out wheat ear).
aha! Swiss Allergy Centre helps
- The booklet "Allergies – simple to explain" is available in English
- For several information go to "Anaphylaxis" and "Anaphylaxis check"
- Emergency allergy cards and App: ehether in haptic form or electronic form
- Other app for smartphones: e-symptoms (in German, French, Italian and English)
- Education (in German) and workshops (German and French) on the subject "Anaphylaxis"
- Experts on the aha!infoline will be happy to answer personal queries: Monday to Friday, 08.30–12.00.
- Products and services awarded the Allergy Seal of Quality – an added benefit for sufferers.
- aha!shop: other booklets and factsheets provides detailed information and are available in German, French, Italian
- Other education and courses on the subjects "Neurodermatitis", "Asthma" (in German)
- We value your opinion. Or would you like to exchange experiences with other sufferers? (Both sides in German)
- Your donation will enable us to provide important services to people with allergies, asthma and neurodermatitis. Your support will be put to effective use. Many thanks.