Coeliac disease and lactose intolerance

Coeliac disease is an autoimmune disorder, which, if not diagnosed and treated with a gluten free diet, can lead to very serious health problems as the small intestine becomes increasingly damaged and its capacity to absorb nutrients is impaired. 

Lactose intolerance can be caused by a lack of lactase, the enzyme that breaks down lactose, which is needed for digestion. This deficiency can be primary, caused by a genetic variation, or secondary, caused by an additional inflammatory bowel condition such as gastroenteritis or celiac disease. After treating the primary cause, lactose intolerance typically improves.

When a person is first diagnosed with coeliac disease, the lining of the gut is still affected by the damage caused by eating gluten. This damage to the intestine can cause the body not to make enough lactase, or that the enzyme that is produced does not work properly. 

Once a coeliac patient is following a gluten free diet, the gut is able to heal and the ability to produce lactase and digest lactose should return. 

The only accepted treatment for coeliac disease is a strict gluten free diet. Lactose intolerance is treated by avoiding food with containing lactose.

Coeliac disease can be tested with a blood sample, but it is important not to remove gluten from the diet beforehand, as the test works by identifying the antibodies that a coeliac patient’s body creates in response to gluten.  

Lactose intolerance is diagnosed using a Breath Test (no other tests are validated) and confirmed by observing the disappearance of symptoms after starting a lactose-free diet.

It is important to seek medical advice and help from a dietitian when changing diets. Both a gluten free and a lactose-free diet pose challenges and may lead to imbalances in nutrition if care is not taken.