For many of the millions who suffer from digestive disorder, it's merely a source of irritation and discomfort; for those with coeliac disease, however, it can be a lot more serious.
Cutely described as the body's "food processor", the long, muscular tube that is our gastrointestinal (GI) tract has the ability to sense and react to whatever passes through it.
And to maintain a healthy digestive system, each of us needs to choose the right food to match our individual GI tract's capacity, says Dr Rajnakova.
Food intolerance or allergy is a primary cause of GI tract problems such as reflu, bloating, dyspepsia, diarrhoea, constipation, diverticulosis, gallstones, fatty liver and even GI cancer. It's no wonder these problems are on the rise, she says, when you look at the modern diet: centred on concentrated proteins from meat and dairy products, preferring simple to complex carbohydrates, and laced with harmful additives.
How do you screen fro gluten intolerance and coeliac disease?
We do a physical examination and take a detailed medical history, plus an evaluation of dietary habits. GI tract prbolems show symptoms that may include nausea and vomiting, bloating, abdominal pain, constipation and diarrhoea. Coeliac disease can be detected by a blood test, after which we would do a gastroscopy do confirm the diagnosis.
Tell us about coeliac disease.
It's an immune-based inflammatory reaction in the small intestine to dietary gluten (the storage protein for wheat, barley, and rye), and it affects those who are genetically predisposed to it.
It's a serious condition: the inflammation caused by the body's reaction to gluten damages the lining of the small intestine, reducing it's absorptive surface area, reducing its digestive enzymes and impairing the absorption of important micronutrients. Apart from abdominal pain and bloating, this causes chronic malabsorption, malnutrition, and unhealthy weight-loss.
In cases of lactose intolerance or coeliac disease, bloating is linked to a failure of the digestive tract to break down nutrients into small, absorbable molecules. Other GI symptoms of coeliac disease include diarrhea, oily stools and flatulence; it can also lead to liver disease, anemia, bone disease and skin disorders. Some coeliac sufferers surprisingly, may have no symptoms at all!
What is the cure?
Excluding gluten from the diet completely resolves the problem. But this is not always straightforward - it often requires detailed patient education, proper motivation, and ongoing follow-up.
Any advice on going gluten-free?
This is interesting! An increasing number of people are going gluten-free, mainly because of the huge misconception that gluten-free food is in and of itself "healthier". In fact, there is no evidence that avoiding gluten is beneficial for people who do not have coeliac disease.
My patients with coeliac disease know that most commercially made gluten-free food is highly processed, low in nutrients and loaded with harmful additives. Instead, I advise them to focus their diet on whole foods that are naturally free from gluten.
I advise anyone who suspects that they or a family member may have a food intolerance or allergy to go for proper medical evaluation and testing.
