How Coeliac disease inspired Emily’s cookbook

Liz Nicholls

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Mum & nutritionist Emily Kerrigan tells us how her daughter’s illness inspired her to help others, and shares her local foodie faves, including gluten-free goodies

“The thing with coeliac disease is that not everyone’s symptoms look the same. If you have a question mark over your own symptoms, do take a look at Coeliac UK’s website – they have comprehensive advice to support you.

For my daughter Chloe it meant a lot of stomach upset and just generally feeling poorly. She’d become anaemic which is very common with coeliacs because gluten damages the lining of the gut meaning your body can’t absorb the nutrients in food. Anaemia is actually one of the first markers that can show up in GP tests before you get a diagnosis of coeliac disease. We’d figured out Chloe’s issues were due to something she was eating but when the diagnosis came back it was still a shock. You realise in a split second that nothing will ever be the same. Every school lunch, every snack box, every meal at home, meals out, meals at family and friends, holidays: it all needs pre-planning.”

Q. Do you think Coeliac disease is still widely misunderstood?
“Very much so. For a start it’s an autoimmune disease, not an allergy or an intolerance and definitely not a dietary fad or preference for someone with coeliac disease. Even one crumb of gluten is harmful for a coeliac and avoiding cross-contamination is crucial. It’s not something you can grow out of either – it’s a lifelong condition where the only current treatment is strict gluten avoidance. The lines I hear most often are ‘well it’s easy these days with all the free-from products in supermarkets’, ‘one crumb won’t hurt’ and ‘it’s not that serious though, is it?’. None of these are true!”

“Coeliac disease is definitely not a dietary fad or preference for someone with coeliac disease”

Q. What has been the most rewarding aspect of writing this book?
“The book is for everyone who needs to eat gluten-free but the inspiration for writing it was my daughter. I’ve already watched her cook the waffles and pancakes from it without my help which was an amazing moment to see her following the recipes and cooking it all independently. I hope she’ll come back to the recipes time and time again as she gets older.”

Q. What do you love about local life?
“We moved from West London to Oxfordshire when the kids were little. We’re on the border with Bucks, too. We’re lucky to have Oxford within easy reach and London still a train ride away but also to be surrounded by countryside. We can walk from our front door up onto the Ridgeway and cycle down the Phoenix Trail to Thame.”

Q. Are there any local shops/suppliers you really rate?
Chiltern Ice Cream is a family-run fantastic small producer. They make their ice cream with milk from Lacey’s Dairy up the road and all their lovely flavours are GF – we like sea salted caramel and morello cherry. We buy ours from Haddenham Garden Centre.”

Q. How about restaurants – maybe there are some that cater to GF better?
The Beech House in Beaconsfield and Cote in Marlow both have a good selection of GF dishes. The Ivy in Marlow also does a non-gluten afternoon tea whilst Coopers is perfect for GF avo on toast and great coffee. Not far from Bucks, Honest Burger in Windsor is fantastic for gluten-free burgers.”


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Gluten-related disorders

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If you are presenting with any chronic health or wellbeing conditions that cannot be explained, then a professional assessment should be advised for the following disorders.

Gluten-related disorders (GRDs) are fundamentally caused by the inability of the body to properly digest gluten (the storage protein in grains), typically driven by imbalances in the bacterial species of the gut in combination with genetic predisposition. If identified, eliminate gluten from a diet permanently in order to repair the damage.

Coeliac disease (CD) is the autoimmune variant of GRDs where the immune system attacks and destroys the small intestine reducing the ability of the body to absorb nutrients. CD can be diagnosed using a combination of blood, genetic and physical assessments.

Non-coeliac gluten sensitivity (NCGS) are not an auto-immune disease, but is no less serious. This evidence is based upon results of a large study that reviewed 351,000 intestinal biopsies clearly showing that there was not only just as much inflammation detected with NCGS as with CD, but also that the increased risk of early mortality was 72% with NCGS compared to 39% with CD.

There is also a “new kid on the block” called non-coeliac wheat sensitivity (NCWS), where gluten is not necessarily the trigger, but instead significant immune system reactions are being triggered by other components of wheat. You can start to appreciate that both gluten and wheat can have serious implications on individuals that do not have CD but instead NCGS/NCWS.

Simply eliminating wheat or gluten, in your diet, before you have had a professional assessment is not advised.

Call Mark BSc (Hons) BA (Hons) mBANT CNHC on 0118 321 9533 or visit www.entirewellbeing.com

Some problems with coeliac disease

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coeliac

Coeliac disease (CD) is not a minor ‘intolerance’ to gluten, it is an autoimmune condition in which the body’s immune system attacks the small intestine, reducing the ability of the body to absorb nutrients from food. If left undetected, CD has the potential to cause significant long-term health complications. CD is one of the most common lifelong disorders in north America and Europe and only one in eight coeliacs are ever diagnosed. These are disturbing facts.

Diagnosis of CD currently requires a positive blood test and then subsequently the detection of damage to the small intestine via an endoscopy. The first problem is that less than 50% of coeliacs are presenting with the classical symptoms of diarrhoea and abdominal cramping. The majority of coeliacs are ‘silent’ in their presentation – no overt digestive symptoms but signs and symptoms including anaemia, osteoporosis, arthritis, neurological degradation, depression, fertility issues, migraines and chronic kidney disease. This is likely to have a significant impact on whether testing for CD is even considered.

The next potential issue is with the blood testing itself. The standard NHS test for CD is good if you are presenting with significant damage to the small intestine and your immune system is functioning properly. We know, however, that damage to the small intestine is gradual and can take years or even decades to manifest; the immune system is often underperforming and the markers measured for are not broad enough. This can lead to very high rates of false negative results (up to 70%), which is dangerous if you are told it is fine to consume gluten when in fact it is not! Remember you have to be eating gluten and not taking any steroid or immune-supressing medication for any blood test to have half a chance of picking up an issue.

Finally, it is possible to have positive blood markers for CD and no small intestine damage – ‘latent’ CD (over and above the fact that the biopsies can often miss ‘damaged’ areas of the small intestine). Is it any wonder CD is such a poorly diagnosed and managed condition?

Call Mark BSc (Hons) BA (Hons) mBANT CNHC on 01183 219533 or visit www.entirewellbeing.com