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Coeliac Awareness Week 2014

What causes coeliac disease?

Most people would probably associate coeliac disease with an allergy or intolerance to gluten; it is in fact an autoimmune condition. In cases of coeliac disease, the immune system mistakes a substance found inside gluten called gliadin as a threat to the body and will then go on to attack the healthy tissue cells. These attacks can damage the surface of the intestines causing it to become inflamed.

The surface of the intestine is covered with millions of tiny tube shaped growths called villi and they help with increasing the surface area of your intestine and assist with the digestion of food more effectively. However in coeliac disease, the damage and inflammation to the lining of your intestine flattens the villi, therefore reducing the digestion process. As a result, your intestine is no longer able to digest nutrients from your food, leading to the symptoms of coeliac disease such as, diarrhoea and weight loss. It is not clear what causes the immune system to act in this way, but it is thought to be a combination of genetics and environmental factors.

Increased risk

It is not known exactly why people develop coeliac disease, or why some have mild symptoms while others have severe symptoms. However, there are factors which are known to increase your risk of developing coeliac disease.

  • Family history: Coeliac disease often runs in families and if you have a close relative with the condition, such as a parent or sibling, your chance of developing it is higher.
  • Environmental factors: If you have previously had infections of the digestive system such as gastroenteritis or a gluten based diet during the first three months of childhood, these factors could play a part in developing coeliac disease.
  • Other medical conditions: Type 1 diabetes, ulcerative colitis and some neurological disorders such as epilepsy are conditions associated with coeliac disease.
What is gluten?

Gluten is a common protein found in wheat, rye and barley. Gluten gives dough the spongy – elastic texture and aids in baking. Foods like bread, cake, biscuits, pastry and pasta all traditionally contain gluten and may be unsuitable for people living with coeliac disease. There are also other food sources that contain gluten and they may not be quite so obvious, for example:

  • Beer
  • Some processed meats e.g. sausages
  • Cornflour (wheat derived)
  • Stocks and gravies
  • Icing sugar mixture
  • Mayonnaise, vinegars, mustards and pickles
  • Many foods labelled ‘wheat free’ (which may have other cereals in them, such as barley or rye)
  • Some medications
Treatment of coeliac disease

There is no cure for coeliac disease it appears that avoiding foods containing gluten is the only way to avoid the symptoms caused by the immune reaction. The lining of the small bowel needs time to heal and symptoms can disappear in as little as 2-3 weeks after gluten is cut out completely.

Travelling abroad with coeliac disease

Travelling abroad for either pleasure or business can cause a great deal of concern if you have a medical condition like coeliac disease. No one wants to be unwell when away from home so, with a little advance planning and research, you can follow a gluten-free diet wherever you are in the world.

Plan in advance

If you have requested in-flight meals as part of the package, ensure your tour operator is aware you will require gluten-free meals. If you have opted to stay at your accommodation on an all-inclusive basis, you may be able to arrange gluten-free meals as part of your package so it is worth checking in advance.

When travelling independently, research the local food and whether it is suitable for a gluten-free diet. Identify which foods you can rely on in an emergency and just in case, it may be worth packing a small supply of your own gluten-free snacks, you never know when you may need them. Remember though to check with your airline if your gluten-free products can be brought into the country you are visiting. Also check if you are allowed to carry them as part of your hand/hold baggage allowance, as some may impose restrictions and confiscate non-permitted food.

Locate the closest public medical clinic to your accommodation and check the opening times prior to departing for your holiday destination. Also check what the telephone number is that you dial in the event of a medical emergency, just in case you need an ambulance.

You can find 35 information leaflets for countries around the world on the Coeliac UK website. They provide translations and useful phrases which may help you prepare for your trip and make life easier while you are away.

Specialist medical travel insurance

Ok, so you’ve booked your holiday, pre-booked your in-flight meals, checked for the closest medical clinic and the next and most important advance planning should be, buying travel insurance to cover your coeliac disease.

Some people may think that you don’t need a specialist policy to cover this medical condition, but what would happen if you had a severe reaction to the local food and you needed emergency medical assistance. Hospital costs can be high in Europe and even worse in the USA and if you needed to be hospitalised because of your condition, you could be left with a massive hospital bill if you didn’t have suitable insurance.

Free Spirit can offer appropriate insurance to cover coeliac disease to ensure you have the protection you need when away from home. As long as you have declared all of your medical history including your coeliac disease, we will provide you with a medical emergency team at the end of a phone. They will be on hand to guide you through finding suitable medical help, arranging payment of hospital bills and repatriation back to the UK if medically necessary. Don’t cut costs and travel unprotected, just in case!

Safeguarding in resort

When you have reached your holiday destination, try and book restaurants in advance if you know they have a gluten-free menu. Better still, speak with the chef to ensure the menu items have no hidden ingredients and they are aware of your specific dietary needs. Go with your own instinct, you know your body better than anyone and if you are unsure about the food, don’t risk it!

If you are staying on a self-catering basis and buying your food from the local supermarket then you will be pleased to hear that all packaged foods in the EU are covered by the same food labelling legislation as in the UK. Food manufacturers must list all ingredients, regardless of the amount used and this includes grains such as wheat, rye, barley and oats.

As long as you are medically fit to travel, leaving home and seeking out new holiday destinations and adventures abroad should be available to everyone, even if you have coeliac disease. The key to a successful trip abroad is the advance planning, so don’t let this be your down fall and risk wishing you had not left home.