FAQs
Frequently asked questions.

Coeliac disease (in the technical language also called gluten sensitive enteropathy/sprue)

Celiac disease (technical term is gluten-sensitive enteropathy/sprue)

Coeliac disease is a permanent intolerance of the organism towards gluten. It can also be seen as an auto-immune illness caused by the gluten contained in the grain types wheat, spelt, rye, barley, couscous and green spelt. In addition to the gluten as an antigen the genetic predisposition and further, partly still unknown factors are the premise for the development of a gluten intolerance. Coeliac disease belongs to the most wide spread chronic diseases in the world. In Europe, North Africa and areas where the majority of the population is of European descent (Australia, USA, Canada) the frequency of coeliac disease is about 1%. The only scientifically approved therapy is a life-long strict gluten-free diet.

Wheat allergy

Wheat allergy is an illness inducing defence reaction of the body towards various proteins in wheat. Sensitization via the airways through inhaling grain dust leads to the so-called baker’s asthma. If, however, by eating wheat a sensitization occurs in the gastro-intestinal system this may lead to a classical food allergy of the type lgE. With children wheat is one of six main allergens. With adults this allergy occurs less frequently, as in most cases it disappears again by the time the children reach school age. The same as with coeliac disease the only effective therapy is a strict avoidance of the triggering allergen, whereby due to the similarity of the allergens very often not only wheat, but also wild wheat, durum wheat, small spelt, Emmer wheat, Kamut, wild spelt, spelt and green spelt should be eliminated.

With a wheat allergy it is necessary to primarily avoid wheat, with coeliac disease, however, all wheat types containing gluten (wheat, barley, rye, spelt, triticale, Emmer wheat, green spelt, small spelt, bulgur, couscous) must be strictly avoided.

There are two types of fructose intolerance.

• Hereditary fructose intolerance, a hereditary disorder of fruit sugar metabolization, is a rare enzyme defect involving the breakdown of fructose at the liver level. It is caused by a lack of the enzyme aldolase B. The consequence is mild to severe hypoglycemia (low blood sugar).
• Intestinal fructose intolerance, usually called fructose malabsorption is widespread. About 30-40% of the population is affected. The cause of fructose malabsorption is a deficiency in the GLUT-5 transporter protein, which normally transports fructose across the mucosa of the small intestine. In cases of fructose malabsorption, this does not occur. Instead, the fructose reaches the large intestine causing complaints such as bloating, abdominal pain, and diarrhea. Treatment against fructose malabsorption consists of a low-fructose diet, where the individual tolerance limit for fructose is very subjective. Sugar substitutes, sorbitol, mannitol and xylitol should also be avoided as they further impede fructose absorption. According to some studies, foods that contain more glucose than fructose are better tolerated. In this regard, there is a list of permitted foods.

In cases of celiac disease, due to damage to the mucosa of the small intestine, temporary fructose intolerance may develop. This generally disappears as soon as the mucosa regenerates through a gluten-free diet.

No, it is not. There is an essential difference between allergy and intolerance. Even though the primary cause of both diseases is grain protein, the mechanisms triggered by intolerance are fundamentally different.

In food allergy, the immune system reacts violently to foods that are harmless in themselves. The body perceives allergens in the food as foreign bodies and sets off an immune reaction. The result is severe allergic reactions, up to and including allergic shock. The body’s reaction becomes visible through:

• Skin irritation,
• swelling,
• itching in the mouth or throat,
• nausea and vomiting.

The worst consequence is an acute overreaction in the form of shock, which must be treated immediately. Triggers of allergic reactions are found in numerous foods such as milk, egg, soy, fish, wheat, celery, mustard and nuts.

Food intolerances, on the other hand, affect the body’s metabolism but not its immune system. The symptoms are similar to those of a food allergy, but there is no risk of allergic shock. There are, however, numerous non-allergic incompatibility reactions that cause different symptoms in those affected. One example: the enzyme necessary to break down a nutrient is missing or inactive. The result is a disturbed metabolism, whereby the body cannot digest food components or can only digest them incompletely. This is why flatulence, pain in the gastrointestinal tract, constipation and diarrhea often occur. With intolerance, small amounts of a food can usually continue to be consumed. If the affected food or food ingredients are avoided or reduced, the symptoms usually disappear quickly and a symptom-free life is possible.

There are actually people where coeliac disease has been excluded but who, nevertheless, have symptoms similar to those of coeliac disease when they eat food containing gluten. This phenomenon is called gluten sensitivity or wheat sensitivity and is being researched quite actively at the moment. However it is not a milder form of coeliac disease as the gluten sensitivity is not immunological and no antibodies are formed. The wheat sensitivity describes an intolerance towards wheat components. Possibly the amylase-trypsin-inhibitors (ATIs) associated with products containing gluten are the cause and not the gluten contained in wheat. It is important though to always speak to a doctor, as only they can really determine the cause of the symptoms and give you a correct diagnosis.

Coeliac disease symptoms:

• Innate autoimmune reaction
• Reduction of the villi in the intestine
• Typical enteropathy

Wheat sensitivity symptoms:

• Unexplained immunological reaction
• No enteropathy