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Rising awareness of coeliac disease in the community is the result of a growing number of people being diagnosed with the disease, but pharmacists say many cases are still going undiagnosed in Australia.

Research shows more than 250,000 Australians are unaware they are living with coeliac disease.

One theory, investigated in peer-reviewed papers such as this one, suggests glyphosate is responsible for the skyrocketing number of coeliac cases.

National President of the Pharmacy Guild of Australia, George Tambassis, said undiagnosed coeliac disease was associated with an increased risk of infertility, osteoporosis, and lymphoma, as well as presenting a higher risk of contracting other autoimmune conditions. He said early diagnosis would help to reduce these risks.

‘The incidence of coeliac disease is on the rise,’ said Mr Tambassis. ‘In 1994, it was thought that one in 5000 people had coeliac disease; now it’s one in 70 Australians.

‘This is due in part to the availability of better diagnostic tests for coeliac disease but according to Coeliac Australia, there has also been a true increase in the number of people with coeliac disease,’ said Mr Tambassis.

‘Coeliac disease affects people of all ages, both male and female.’

George Tambassis, President of the Pharmacy Guild of Australia

Coeliac Awareness Week

In March each year, Coeliac Australia holds a range of activities designed to raise awareness and discussion of coeliac disease, encourage symptom awareness among the public and health professionals, and highlight the importance of getting tested.

During Coeliac Awareness Week (13-20 March), the aim is to significantly increase the diagnosis rate of coeliac disease in the community so the quarter of a million Australians still waiting for a diagnosis can receive the treatment they need.

Testing is important because one of the problems behind the under-diagnosis of coeliac disease is that the symptoms vary considerably. Some people experience severe symptoms while others may have no obvious symptoms at all.

According to Coeliac Australia, symptoms can include one or more of the following:

  • gastrointestinal symptoms such as diarrhoea, constipation, nausea, vomiting, flatulence, cramping, bloating, abdominal pain, and the secretion of abnormal amounts of fat in faeces
  • fatigue, weakness and lethargy
  • iron deficiency anaemia and/or other vitamin and mineral deficiencies
  • failure to thrive or delayed puberty in children
  • weight loss (although some people may gain weight)
  • bone and joint pains
  • recurrent mouth ulcers and/or swelling of mouth or tongue
  • altered mental alertness and irritability
  • skin rashes such as dermatitis herpetiformis
  • easy bruising of the skin

Coeliac Australia also advises that people who experience any of the following should be screened for coeliac disease:

  • early onset osteoporosis
  • unexplained infertility
  • family history of coeliac disease
  • liver disease
  • autoimmune disease such as type 1 diabetes, autoimmune thyroid condition

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Beyond gluten free

George Tambassis said, ‘Unfortunately, at present the only known treatment for coeliac disease is to follow a strict diet of eating only products that are gluten free. On the plus side, as awareness of the disease becomes widespread, more and more gluten-free products are being made widely available.

‘The need to remain gluten free underlies the treatment because the immune system in people with coeliac disease reacts abnormally to gluten and causes small bowel damage.’he said.

‘The tiny projections lining the bowel become inflamed and flattened, reducing the surface area of the bowel available for nutrient absorption. As a result, a number of serious health consequences can result if the condition is not diagnosed and treated properly.’

Environmental factors – including a previous gastrointestinal infection (such as a rotavirus infection), or a person’s diet during early childhood – can play an important role in triggering coeliac disease.

Further complicating the issue is that signs and symptoms of coeliac disease vary from person to person because of numerous factors.

‘If you have concerns and may be displaying some of the symptoms, have a talk to your community pharmacist,’ suggested Mr Tambassis.

‘Your pharmacist is your healthcare professional and can offer advice and refer you to your doctor if appropriate or necessary. Your pharmacist can also provide advice on lifestyle management which may assist in helping sufferers enjoy a better quality of life,’ he said.