Coeliac disease: when gluten causes problems in the gut

Zöliakie: Wenn Glutenunverträglichkeit auf den Darm schlägt

Eating gluten-free is not so easy. Gluten isn't only found in wheat, but in many types of grain, ready-made products and spice mixtures too.

What is coeliac disease?

Grains such as wheat, rye and spelt naturally contain the glue protein gluten. In people with coeliac disease, gluten damages the mucous membrane of the small intestine because the villi of the small intestine are destroyed, thus reducing the surface area of the intestine. This makes it harder for the intestine to absorb nutrients. The result can be deficiency symptoms such as calcium deficiency – one late effect is osteoporosis, for example.

What is gluten?

Gluten is a protein, also called glue protein, which is found in various types of cereals. It’s found naturally in wheat, rye, barley and spelt, but also in many processed foods as an additive. Those with the condition can be guided by the official gluten-free symbol, the slashed ear of corn.

Cause of coeliac disease

Across Switzerland, an estimated 1% of the population is affected by gluten intolerance. The condition is clearly distinguishable from gluten sensitivity and wheat allergy, a classic food allergy. This is because there are no antibodies and the small intestinal changes typical of coeliac disease aren't present in this case. Despite intensive research, the cause is still not one hundred percent clear. Genetic predispositions or infections rank high on the list of possible triggers. In addition, a disease rarely comes alone – it occurs in conjunction with diabetes type 1, for example, or autoimmune diseases of the thyroid gland and the skin.

Coeliac disease symptoms

As is often the case, the symptoms are varied and don't automatically manifest themselves in digestive problems. Children and adults exhibit different symptoms:

Symptoms of coeliac disease


  • weight loss
  • loss of appetite
  • diarrhoea
  • bloated stomach
  • stagnated growth
  • delayed development
  • weepiness or irritability

Symptoms of coeliac disease


  • fatigue
  • anaemia
  • diarrhoea
  • constipation
  • stomach pain
  • loss of weight and strength
  • infertility or aching bones

Diagnosis of gluten intolerance 

If coeliac disease is suspected, the gastroenterologist will take blood samples and look for coeliac antibodies in the blood. To assure a correct diagnosis, they will also carry out an inspection of the small intestine and take tissue samples. It’s important to know that anyone who eats a gluten-free diet in advance makes the diagnosis more difficult. In other words: first wait for the diagnosis and then start treatment.

Late effects if coeliac disease isn't treated

Late effects of untreated coeliac disease can include osteoporosis, anaemia due to permanent deficiency symptoms or small intestinal lymphoma due to changes in the villi.

The solution: gluten-free diet

Coeliac disease can't be cured, but it can be effectively treated with a lifelong gluten-free diet. The mucous membrane of the small intestine usually recovers quickly and symptoms decrease. Even if you’re free of symptoms, it’s advisable to go for a check-up at least once a year to clarify possible deficiency symptoms and check your current diet.

Gluten isn't only found in cereals, but is also hidden in processed foods such as spices, crisps and sausages as emulsifiers, flavourings and binders. The general advice is to study ingredient lists for wheat starch, barley malt extract or malt and look for the gluten-free symbol!

Gluten-free foods

The easiest way to follow a gluten-free diet is to stick to natural and gluten-free foods. A gluten-free diet is neither one-sided nor bland. People with the condition can eat all forms of fruit and vegetables, natural meat and fish, nuts, dairy products, pulses and carbohydrates such as potatoes, quinoa, corn, rice and millet. In addition, the choice of gluten-free flour and products has increased enormously in recent years.

Gluten-free alternatives

Contain gluten Gluten-free
Gluten-free bread made from potato flour, buckwheat, chickpea or quinoa flour
Toast Rice cakes
Pasta Potatoes or pasta made from lentils, chickpeas or beans
Couscous, bulgur Rice, quinoa
Muesli, cornflakes Puffed quinoa, amaranth or millet
Marinated meat, sausages Self-marinated meat with herbs, homemade burgers and self-breaded with sesame seeds
Fish fingers Natural fish or homemade breaded fish fingers with chopped nuts or gluten-free flour
Wheat/rye/spelt flour Buckwheat, maize, rice, potato, cassava, soy, almond flour
Spice mixtures, bouillon Fresh herbs, garlic

Caution! Even small amounts can trigger complaints

50mg of gluten, i.e. a small crouton in a salad, can already be enough to trigger symptoms in those with the condition. It’s therefore important to protect yourself from contamination, even at home. Follow these simple tricks to ensure a gluten-free diet.

  • Store gluten-free food and food containing gluten separately from each other
  • Clean work surfaces, pots and kitchen utensils regularly
  • Buy kitchen appliances, such as a toaster, twice over

Recipe for gluten-free buckwheat crepes

Savoury buckwheat crepes completely
Savoury buckwheat crepes completely free of gluten

Ingredients for 2 persons


  • 50g buckwheat flour
  • 50g chickpea flour
  • 1/2 tsp. salt
  • 150ml milk
  • 150ml water
  • 1 egg
  • 1/4 tsp. gluten-free baking powder
  • 1/4 bunch parsley, chopped

Sauce and salad

  • 3 tbsp. olive oil
  • 1 onion, finely chopped
  • 2 sprigs rosemary
  • 1 garlic clove, crushed
  • 300g mushrooms, quartered
  • salt and pepper
  • 1 tbsp. cashew butter
  • approx. 100ml water
  • 1 bag baby spinach
  • 1 tbsp. balsamico vinegar
  • 2 tbsp. sunflower seeds


  1. Put all the ingredients for the pancake batter in a blender and mix.
  2. Cover the batter and let it rest for about 10-15 minutes.
  3. Meanwhile, prepare the mushroom filling. Heat 1 tbsp. olive oil and sauté the onion in it. Add the rosemary, garlic and mushrooms. Sauté until the mushrooms are soft. Don't stir them too often. The mushrooms should be allowed to brown a little. Finally, season with salt and pepper and add the cashew butter and water.
  4. Fry the pancakes in olive oil on a medium heat until golden brown.
  5. Serve the pancakes with the sauce and a simple spinach salad. Season the spinach with olive oil, balsamic vinegar and salt. Sprinkle with sunflower seeds and serve.
Further information and help:

What would you like to read now?

Well looked after with CSS

Nutrition counselling

Make long-lasting changes to your eating habits with help from professionals.
To the offer

Health Coach

Get personal advice on health-related matters.
Discover the service

Check symptoms

Get a recommendation, book a doctor's appointment and much more.
Discover the Well app