Coeliac Disease Explained - Gluten Sensitivity - A to Z of the NHS - Dr Gill
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- Опубліковано 14 тра 2024
- Coeliac Disease Explained - A to Z of the NHS - Dr Gill
It seems that Coeliac disease is on the rise, or is it just that we are now more aware of gluten sensitivity. What's the difference between full-blown coeliac disease and gluten intolerance.
What issues are patients likely to encounter with coeliac disease? More importantly, why can patients be sure they have coeliac disease, but the tests are coming back clear?
We discuss the pitfalls of coeliac testing, and how this may mean the need to explain to a patient the differences between a diagnosis of coeliac and a probable diagnosis of gluten intolerance
#DrGIll #Coeliac # NHS
You can now consult via video or in person with Dr Gill at Dr Finlay’s Private Practice - www.drfinlays.co.uk/services/...
00:00 - Introduction
00:41 - What is Celiac Disease?
02:01 - Spectrum of Gluten Sensitivity and Celiac Disease
03:46 - Symptoms and Diagnosis of Celiac Disease
05:52 - Treatment and Management of Celiac Disease
07:56 - Lifestyle Adjustments for Celiac Patients
08:55 - Autoimmune Aspect and Gut Microbiome
10:56 - Closing Thoughts
I was recently diagnosed with Coeliac Disease. I never once considered it as a possibility BECAUSE I’ve never really had any bowel-related symptoms. Not enough medical professionals (in my opinion) fully understand that silent coeliac is a thing. My antibody test was 10x higher than normal! My gut is still damaged! But I’d never have considered this to be the cause of my fatigue/anaemia/headaches/depression. Good job I finally found a good GP who took me seriously instead of dismissing me as someone who just didn’t look after herself very well. It only took 15 years 🙃
Same! I literally could have written this!
I have only one question. If your gut was damaged (I assume you mean the villi damaged) how could you not have GI issues? Personally, I thought my chronic bloating, gas, diarrhea was normal. Of course it all went away on the GF diet.
My sister-in-law is celiac (it’s genetic in her case) and one of the frustrations of the popularity of gluten free diets for her was people assuming that it was simply a lifestyle choice and not a true allergy like in her case so she’s had to be more careful when going out to eat with potential/accidental cross contamination from people unaware of the dangers for her. Great topic!
If she has coeliac she doesn’t have a “true allergy”. She’s not allergic to gluten. She has an autoimmune condition that causes her body to attack itself every time it detects there is gluten in her system. Might be tricky to see the difference, but there is one :)
@@eilzmo great clarification, I should have better specified when I wrote that but failed to from being tired, thanks for correcting it for me! (I know the difference but forgot others might not).
From all the coeliacs around the world, thank you buddy! :)
👍
Doc in blue nailed celiacs! Well done!
The day I came across Dr IGUDIA UA-cam channel was the day I started living a more comfortable life again after using his herbs medication in curing my Coeliac disease
I’ve been gluten free for 7 years now despite not getting a positive coeliac test result for reasons you discussed, however, I did get a strong positive skin prick test result for wheat. I also believe much of what we still have to learn about the microbiome will strongly influence how we treat many illnesses in the future
I genuinely think the microbiome is going to be one of then next medical frontiers
Anaemia is also a symptom. It was the only one I had for 4 years before Coeliac diagnosis.
I feel really smug, ive had every type of poo on the chart at some point in my life
🤣🤣 it’s not a Pokémon chart. We don’t need to “collect the lot!”
Almost cruelly, this video was proceeded for me by an advert for deep dish pizza.
Oh that’s just not cricket!!! ☹️
I was actually eating a pizza when I pushed play. 🍕
You just explained exactly what happened to me with a negative test initially but went GF and bowel, body and mind never been better. Keep up the good work ASMR king
Perfect! I’m so glad to hear you got the improvement 😊
This is wonderful, thank you! Unfortunately too many doctors still think coeliac is rare and it can take a lot pushing to get investigations for it.
I have Dermatitis herpetiformis which is linked to coeliac disease, even though various blood tests have been negative. I'd barely laid on the table for my abdominal exam with the consultant and he spotted the characteristic blister type rash on the inner elbows. Course of action was a colonoscopy to rule out any other large bowel pathologies (based on symptoms) and a GF diet. Always ensure your patients are appropriately exposed for the abdo exam!
In another life I'd be a medic, for now I'll stick to hobbyist in anatomy & physiology
That’s a really good point. That is why in the abdo exam, we start off with exam with the hands.
That was a good spot by the consultant!
This has got me thinking. Is there a reason why the blood test seems to be so insensitive to tTG and IgA? Is IgA deficiency skewing the results that common?
It’s not that it’s insensitive. It’s that many people naturally reduce the foods they notice that make things worse. So you are reducing the response the test looks for
Thanks again James:)
I recently found your channel and to say i'm fascinated by your wealth of knowledge is an understatement.
I live in northern canada and love your accent.
Thanks for joining us! We also try to be relatively active on the community section here too!
Hope you stay around for the rest of the A-Z series.
We’re about to start prepping the E’s, any suggestions?
@@DrJamesGill endometriosis would be a great one!
No worries. That is CERTAINLY on the list
Hi there
Really enjoyed your video ....after many years of chronic symptoms I'm day 8 of being gluten free
I have years of Anaemia and other deficiencies plus lots of other markers for celiac but as mentioned a negative blood result
I'm doing pretty well so far and hoping to finally start feeling better
Best wishes Helen xx
This was very helpful iv just been given a colonoscopy and being advised its celiac the dr has booked me in for a gastroscope exam to give me a full diagnosis , iv struggled understanding fully as most things online are very sciencie , you went into detail but also gave the “everyday persons” explanation 👍 brilliant video and advice thank you
Glad this helps.
Thankfully Celiac shouldn’t cause any issues if you are able to avoid the gluten 😊
I didn’t realize the correlation of fiber intake and Crohn’s likelihood. As always, gentlemen, great information! Oh and please cover C. Diff. Terrible stuff, but I’d like to hear your experiences.
We’re moving onto the D’s now. But maybe if there is the opportunity
Such an interesting disease and great that it's getting wider awareness. Celiac (why the different spelling between US/UK?) runs in my extended family, apparently the severe form. My aunt is in severe pain if she has accidental gluten exposure. My cousin had failure to thrive as a child, was a very tiny and pale kid and always complained of stomach pain, but it was before celiac was widely known. When he finally was diagnosed at age 8 he made almost immediate improvements, shot up like a weed, and now is 6'8 as an adult! Subsequently, 3 other kids in the family were also diagnosed (although it wasn't impacting them as visibly).
It’s great to hear of that huge improvement, but shame it took so long.
The test is often part of a screen due to how vague the symptoms can be
Another great vid doc!
👍
This was so interesting and informative! I was diagnosed with Coeliac at 4y/o and have seen the Gluten free section at supermarkets evolve over the years. I used to get bread/pasta/biscuits on prescription however it was stopped about 12 years ago when I was told the NHS no longer funded it!! Not sure if this was a nationwide thing 🤔 thanks Dr James for another great video!
It is still active, but it may be that certain CCGs have restricted it
Thank you doctor!
You are welcome!
I’m a Coeliac Thank You for this! 👍🏻
I’m sure you’ll already know this already
@@DrJamesGill Beautifully presented as always. Is it true that if a coeliac continues to consume gluten that in time they can develop Non Hogkins Lymphoma? What I love about you doing this video is it helps raise awareness as there is a stigma that a gluten free diet is a lifestyle choice but it isn’t and you have explained why 👌🏻
I’m not certain re NHL. But it certainly wouldn’t be a good thing to do as any recurrent damage can lead to malignant change
Same reason why we want acid suppressing medications in reflux to reduce risk of malignant changes
Was recently diagnosed so this video is a great help, thank you. I did see somewhere that because I was diagnosed at 20, I have a 27% chance of developing another autoimmune disease. Concerning, if true
I don’t know the number off the top of my head. But this is a big reason why people need to avoid gluten when they have a positive test
HAPPY EASTER 🍇🌾
SO EXCELLENT !!!!
👍
They did a terrible job teaching us about celiac disease (and other significant gut issues) in nursing school. The infant gut microbiome has become a new area of fascination for me over the past few years, which in turn has led to more study on the adult microbiome... So much more to learn, it's exciting!!! And yes, we medical people do love to get the details of our patients bowel habits 😂
I really think the gut microbiome is going to be a whole new frontier
The diet helps a lot but it doesn't stop it from causing on going problems.
This is very informative Dr Gill, thank you! I think I might need to get blood test done. I am gluten intolerant and also happen to have persistent anemia (despite of daily iron b12 supplementation). Never realised they could actually be related 😯
It can often be a surprising diagnosis
I was diagnosed Coeliac and later with Dermatitis Herpetiformis. If you have DH you ARE Coeliac. My weight when I was diagnosed at 35 was 50kg. After 2 years on a strict GF diet my weight went to 85kg. I am now 77 and I MUST avoid ALL gluten. My weight is 73kg. I also take 1200 mcq of Vit B12 daily to avoid mouth ulcers. Totally avoiding gluten when eating out can be a pain. If some gluten gets through I can have 6 or 7 bowel motions when I get home. Its not worth it.
I have coeliac & they found it while testing me for haemochromatosis (my auntie has it), interesting to hear the info in this vid! Not everyone has symptoms which is crazy to me.
I test for it quite regularly now on a general screen. But is concerned about coeliac as the presenting complaint, I will ask that they eat the gluten to ensure we get a valid test
When I accidentally have Gluten I have a horrific migraine, throw up violently, gut ache, exhaustion, pebbledash the bog with projectile (when the world falls out your arse) light orange poo, and have vitamin and mineral deficiencies too. I also have a few other conditions too.
yes, it's always 30 minutes to an hour before the sweating starts and then gates to hell are opened up and no one wants to see that.
Imagine dr gill going to one of his videos of a medical practice and then realise he has been bombarded with comments of asmr then later finding out he is one of our gods
Hello good doctor. 👍🏿
CAC Curcumin capsule is prepared from the herb turmeric. The herb turmeric (Curcuma longa) contains the active compound curcumin that shows antioxidant, anti-inflammatory, analgesic, & immuno-modulator properties. These properties deal with the pain in abdomen, loss of appetite, indigestion, & improve overall digestion. It helps in building up the immunity of the small intestine to deal with the coeliac condition.
Dr Gill, what bacterial flora would you recommend for celiacs ?
Great content as ever Dr Gill! My mum suffers from coeliac and it's been crazy to see the growth in awareness and availability of GF foods she can enjoy.
A request if you'll entertain them - something about platelet disorders would be most welcome (specifically ITP from a personal perspective) to raise awareness and inform others.
Down the line yes. Would be a good one to approach
This specialist gp looks a lot like the guy whom did my endoscopy and colonoscopy on Friday..and sounds like him as well. He was called James, but I was told his name was something else lol. But I rarely forget a face And this guy looks his exact double...thanks for sharing, I have to wait for results of biopsies done on stomach...
Nope. I assure you, wasnt me. I’ve not even BEEN in the colonoscopy suit since medical school! 😊
Great information here, thanks. The doctor mentioned oats but I thought that gluten was in wheat, rye and barley but not oats. I've read that oats can have gluten but that's because it sometimes gets contaminated with bits of wheat/rye/barley during processing (if they are all processed in the same facility).
You are exactly right 👍
Soy celiaca, me encantaría poder entender lo que dicen. Se podrá agregar subtítulos en español? 🙏🏼
I was diagnosed with “Coeliacs Disease” 14 years ago. I had a severe bowel issue where I had a bleed from somewhere in my intestines and pencil like feces. I am on the severe spectrum and am effected horribly if I eat anything with Gluten. I haven’t had a normal slice of pizza or a beer in 14 years.. 😩
I’ve not personally tried it, but I do hear good things about the dominos gluten free pizza
Really interesting thanks, can you do one on ulcerative colitis please? This condition is in my husband's family and we are concerned and interested to learn more
we pretty much cover that in the Crohn's video as UC and Crohns are part of the same IBD family - here is the link 😊 ua-cam.com/video/QgYnL6WT084/v-deo.html
I didn't know i was gluten intolerant,i blamed the symptoms on the amount of food i eat as a bodybuilder,but since cutting out gluten all such symptoms have disappeared and ive actually put on muscle maybe due to the fact im actually digesting the food im eating properly maybe?
Great video. I don't think oats contain gluten inherently but are advised against for coeliacs due to cross contamination.
Good point!
All grains contain gluten! Oats just don't contain wheat (gliadin), barley (hordein) or rye (secalin) which is what the 'gluten-free' label really means in most countries. Oats contain the gluten avenin which is OK for most celiacs. In Australia and New Zealand, the 'gluten-free' label really does mean that it contains no gluten!
I went to the doctors with the dermatitis herpetiformis rash for 3.5 years. I was told I had so many things that I can't remember them all. The most ridiculous one being scabies, (which I obviously didn't have or my girlfriend and roommate's in the college dorm would have had it.) It still cost me a few hundred dollars for the cream and to shampoo an entire floor of a dormitory (Thanks Doc!) But one day when I was at the doctor to get my clobetasol cream (The only thing that eased the rash a bit) a nurse saw my elbows and asked if I'd ever been tested for coeliac disease? Because she had it and used to get the same rash. So they told me if I paid for their blood test, that would answer if I had it. So I did. And when my results came in they said "I probably had it." It was more than likely.' So I asked what the next step was? And they said "Gastroscopy" which was free because I live in Ontario, Canada. So I stopped eating gluten and the rash went away and felt good again! Yay, right? No. They needed me to go back on gluten before I did the gastroscopy. Broken hearted, I asked "how long?" They said " At least 3 months. And I had to eat gluten like I had before 😢. So I did it and the rash came back worse than before, and I developed swelling joints (especially in my knees) Started having panic attacks as well. So after 3.5-4 months I finally got a letter telling me my laparoscopy would be another 3+ months of eating gluten, poisoning myself. During that time I had what felt like a heart attack, at school. I was very healthy other than celiac disease. Athlete, worked in gyms and fitness stores etc. I've never been the sAme since that day. Something happened and now the left side of my jaw clenched on its own and I have loud tinnitus in both ears. No doctor has been able to figure it out. I've been diagnosed with Tourette syndrome, been told I may have nerve damage, or a form of epilepsy. I have to take clonazepam everyday just to relax my jaw, tongue and throat. But after 8 months of forcing me to eat gluten I got my gastroscopy and I have celiac disease. It took from 2008-2011 to be diagnosed with celiac disease and I dropped with the heart episode (while being forced to eat gluten) in October 2011 and that shattered my life.
Hi doc 👋 I had a positive tissue transglutaminase IgG, not IgA. Is this actually a celiac disease? Why IgG?
My doctor told me I had gluten intolerance. I wonder if it’s celiac intolerance.
A cholecystectomy can produce sintoms like the one of Coeliac Disease or Gluten Sensitivity?
I have similar sintoms and my doctor keep saying that it's due to not having a galbladder anymore, and to be honest, these sintoms started to occur after the cholecystectomy, but I'm not sure he's right, at first I tought he didn't want to let me take an unnecessary invasive exam, but if it can be diagnosed also with blood exams, why he's pushing to not do it?
Really informative thank you. I had a positive blood test 5 years ago but decided against the biopsy as I didn't want to wait another minute to start the diet let alone the 8 weeks for the appointment (it was seriously affecting my fertility and we really wanted to start a family), I'm now assuming that I do have CD and have strictly followed the diet since but I do often wonder whether I should have followed through with the biopsy for a full diagnosis.
Risk based benefit
You have changed your diet. Hopefully symptoms have improved, and life has also improved.
What benefit is there in confirming a positive test, which is very accurate, and has already - been assumed to - given benefits?
Very true, I now have a lovely family and the GF offerings in the supermarket have dramatically improved.... Can't say I'm not tempted by lovely fresh crusty bread though but it's a small price to pay!
@@DrJamesGill I disagree. As a very sensitive Coeliac, the gluten free life is fairly restrictive and gluten free food is full of sugar and other nasties in order to make it palatable. It is a struggle to maintain adequate fiber levels. Eating becomes something you have to think about very carefully and limits travel as it's not always so easy to get uncontaminated gluten free food. Accidental cross contamination is a real issue and I have been accidently glutened when eating out at friends and restaurants. People should get a definite diagnoses and the gastroscope is still the gold standard. I would hate to be on this diet for life if it was not absolutely necessary!
I love your channel, I really do
Thank you! I hope you find something useful here 😊
@@DrJamesGill where do I start?
Well we started with A on this series 😊
@@DrJamesGill no Dr. James, when I said "where do I start", my point was: I have learnt a lot
Thank you, Dr Gill.
My non-scientific observation is that, if I eat a quantity of food made with that very fine white powder, I have issues the following day.
I recognise them because, if you break a bread roll in two, you'll see that the inside is blindingly white.
In pies, it can be challenging, but you realise it soon because they have a very soft, very gum-like texture.
When shopping, I try to go for the brown flour products (or, if not whole, at least not too refined). When I bake, I now only use less refined flours. They are more easily available and not extravagantly expensive (though they are MORE expensive).
I also avoid common pasta, especially the cheap one. Pasta is often very white, it tastes like nothing and is bad for you. The best supermarkets now offer pasta brands that use better flour. I go for those.
I don't have issues with gluten, but I've tried some gluten free products just out of curiosity. Some of the gluten free pastas get the flavor about right, but the texture is always way off.
@@ressljs gluten free flours lack the proteins that give texture and taste to the final food. That taste is usually replaced with added fats and sugars (and salt).
I would advise people with coeliac diseas to leave those replacements aside.
Rice and corn usually can be used to make pies and cakes for children.
@@idraote Yeah, like I said, I was trying them out of curiosity, not necessity. I noticed that a lot of gluten free stuff sold in stores isn't particularly healthy apart from the obvious gluten issue. For example, a lot of the gluten free flours, like rice, are about as close to pure glucose as possible. One of my coworkers bought into the "wheat is evil" mindset and went gluten free (by his own admission, he was not gluten intolerant). I told him to be careful what he used to replace wheat because he could be swapping a run of the mill carb for alternatives that are even worse.
Early to the doc’s video!
Welcome
Dr Gill, both myself and my dad suffer with hypothyroidism, my dad also suffers with with coeliacs. As I suffer with an auto immune disease, does this make me at a greater risk of suffering from coeliacs later in life?
Coeliac doesn’t often develop in later life. But it would be worth whilst discussing your concerns with your GP
I discovered I was celiac by accident, I was vomiting after everything I ate and I was sent for an endoscopy. My biopsy was inconclusive and the GI told me to go gluten free for a while and to check in after two months. I rolled my eyes at going gluten free but my gut has healed and I've been gluten free since.
That’s great to hear. One of the ways I normally explain that to people is “we treat the patient, not the test result”
Rye is also a cereal Coeliac's cannot consume.
how different is coeliac from ulcerative colitis?
It’s like hay fever compared to COPD
Doctor🇧🇷👍👍👍doutor
👍
Scope confirmed Celiac with hypothyroidism time to see if I've missed anything in the last 10 years.
Hopefully both are managed well now 😊
@@DrJamesGill synthroid for the hypothyroidism and have been stable for year. Zero cheating with gluten as the results are quite volatile and my diabetes managed for now with food. Isn't CD wonderful.
Good that all three are behaving 😊
My mom has refractory celiac disease. It’s horrible. And stopping gluten does not stop her disease :-(
Coeliac is pretty much binary. Is it an intolerance?
@@DrJamesGill no she has blunted villi that do not come back on a strict GF diet. She also has pernicious anemia and must do shots because she hasabsorption issues
Ah sorry. I understand now, I misunderstood. Coeliac with fixed changes. I’m sorry to hear that.
At least she has the diagnosis now and has treatment 😊
We have a rare genetic disorder called CTLA4 Haploinsufficiency and it is the cause of both the celiacs and pernicious anemia. She has a host of other issues as well from the mutation. I assume that’s why hers is unresponsive to healing even on the diet (and she is super strict). She also takes budesonide steroid to help.
I’m not familiar with that. I’ll have to do a little reading
Sour dough pizza! Cmon
You had me at pizza
Love me some gluten.
wait i thought it was 1 out of every 100?
Coeliacs is rubbish and is really frustrating me, I'm lucky to not be at the worst end of the spectrum when it comes to symptoms, but this leads me to cheating by eating regular pizza/drinking normal beer etc, so I'm concerned about the damage I might be doing to myself
The best answer to that I’ve seen it that “medical conditions don’t cheat or take days off”
Continuously damaging your gut can lead to cancer so I wouldn’t do it if I were you!
Cosy weekend
Are you sure you dont have the gene? do 23 and me genetic testing.
HeY DoCtOr Does mY pOo LoOk oKaY??
You’d be surprised how often that is what we are asked!
@@DrJamesGill Hey man, I am 27 and even I check my poo for blood or irregularity. No shame in checking that doo my brother! Could be worth it one day! Keep up the good work :)
💩💩💩💩💩 talk**** coming up next on the Dr. Gill show.
Oats do not contain gluten.They can only be cross contaminated with gluten.