The Parish Magazine February 2023

HEALTH
Dr Simon Ruffle writes . . . Coeliac disease
Writing this early in the New Year is a
little resolution that I am going to get
things done in plenty of time rather
than seeing a deadline as a target!
My hobby is photography. When I first
investigated the subject more deeply,
I didn’t really understand abstract
photography.
Abstract photography is described
as ‘images created using photography
materials and equipment that don't
have an immediate association with the
physical world.’
Irritable bowel disease (IBS) is
the ‘abstract’ of the bowel disease
world. There is no association between
symptoms and any physical changes in
the bowel.
VARIED SYMPTONS
It is a diagnosis of exclusion which
means that we exclude other reasons
for the problems that the person is
experiencing.
IBS has a varied range of symptoms
that fluctuate in time, frequency, and
severity. Pain, bloating, diarrhoea and/
or constipation are features. However,
these symptoms are also associated
with inflammatory bowel disease such
as Crohn’s disease or ulcerative colitis,
cancer, and Coeliac disease.
There is no definitive test for IBS
and therefore ruling out other diseases
leads to the diagnosis.
Important signs of bleeding and
weight loss are rarely seen in IBS but
are seen in other illness. No one knows
why people suffer with IBS but there
must be something wrong and one day
there will be a more effective way of
treating IBS as a disease instead of just
alleviating some symptoms.
FRUSTRATION
Due to the issues described above
getting to the diagnosis can take
some time and it is frustrating for
the patient and the doctor. We hate
not knowing but one skill that all GPs
must master is to live with uncertainty
and keep an open mind, otherwise the
diagnosis will be missed.
Coeliac disease can be dismissed as
IBS as they share a range of symptoms.
Coeliac disease is often discussed
as a gluten intolerance or allergy. It
is not. It is an autoimmune disease.
Essentially eating gluten causes the
body to attack itself. Even small
amounts in sufferers can trigger it.
Gluten is found predominantly in
wheat but also in rye and barley.
Although the attack is usually in
the small bowel, thus leading to the
symptoms of bloating, pain, wind
and diarrhoea, it can also affect other
parts of the body including the skin.
Undiagnosed Coeliac disease will
lead to malabsorption of nutrients
and then anaemia, weight loss and
osteoporosis. Left over years, it can
also lead to lymphoma of the small
bowel.
GLUTEN
Similar to IBS there is no cure and
the only way to control the disease is
not to eat gluten at all.
Taking an iron supplement
and calcium is recommended if
you get any symptoms as cross
contamination of foods is common
and, bizarrely, gluten-free food in the
UK can contain 20 parts per million
of gluten.
Coeliac disease is not rare, and
it is suspected that 1 in 100 people
may suffer from it. Diagnosis starts
with recognising the symptoms and
some simple blood and stool tests.
Following on from this, a biopsy may
be required to confirm the diagnosis.
Cutting gluten out of the diet before
tests can lead to false negatives so
your doctor will ask you to eat gluten
before testing.
The Parish Magazine - February 2023 27
Abstract lights’ by iMagesSRx
Most sufferers can control their
symptoms with diet but lightning
can strike twice and Coeliac disease
sufferers may also have IBS.
More information can be found at
https://www.coeliac.org.uk/informationand-support/coeliac-disease/aboutcoeliac-disease/
however, a little
warning that this site asks you to
accept all cookies, not the best idea for
some unless they are gluten-free!
Love is better for
you than money
Your mental health is the biggest
single predictor of your personal
happiness. Suffering from
depression or anxiety disorders can
devastate your life.
Finding love is also a vital ingredient
for happiness. 'People need to be
needed, and to be in meaningful
relationships', says a recent study by
the London School of Economics.
It goes on: 'Happiness is hugely
affected by the ethos of a society, which
affects everyone in it. For example,
happiness is higher in societies where
people trust each other. Freedom is also
a crucial determinant of happiness.'
The report also found that a boost
in income, or more education, did not
significantly affect our overall wellbeing.
Having good mental health
and someone to love were far more
important.