Dozens if not hundreds of recipes for gluten-free foods can now be found on the Internet, designed to help sufferers deal with this growing problem. Gluten is found in wheat and other foods, and avoiding it can be quite a challenge. However, with proper tests and a healthy lifestyle it can be done. Yahya, a bright four-year-old, has to fight his cravings for fruit like bananas and oranges. High gluten sensitivity forces him to consume a diet that his mother has to devise specially for him, guided by a list of forbidden foods a doctor prepared for her after testing Yahya for gluten sensitivity. Yahya was diagnosed with moderate gluten sensitivity when he was 18 months old. His case became more severe after attempts to re-introduce gluten into his diet after a few months of eating non-gluten foods. Gluten sensitivity, or coeliac disease, is sensitivity to food products containing gluten. Ikram, Yahya's mother, started her quest to discover what was wrong with her son when he was 18 months old. A doctor diagnosed him with stomach flu, but after a while she realised there was something else wrong. A referral to Mohamed Al-Guindi, president of the Egyptian Society for Gastroenterology, led to further tests and eventually a diagnosis of mild gluten sensitivity. “Coeliac disease is a disease associated with the small intestine,” Al-Guindi says. “What happens normally is that the small intestine has a rough outer surface that absorbs nutrients from foods with gluten content. For patients with gluten sensitivity, somehow the small intestine loses the ability to absorb these nutrients and the outer surface becomes flat. “The result is that patients become sensitive to gluten-containing foods. The symptoms can include constipation, diarrhoea or malnutrition because the body does not receive enough nutrition from other sources. “This condition can occur in children or in adults. It is popularly referred to as an allergy, but in reality it is a deficiency since the body does not produce the enzyme that absorbs gluten. For children, it usually starts immediately after weaning when they begin eating cereals. “Their sensitivity to gluten then starts to appear. Unfortunately, there is little awareness of this condition as a disease, and it is not seen as a condition that doctors should look for. Some cases are often not handled well as a result,” Al-Guindi explains. When this situation arises, patients and their carers often have to knock on several doors to find the right cure. Yahya went through a treatment in which his doctor re-introduced wheat into his diet to test for gluten sensitivity. As a result, Yahya went from a moderate to a severe case of gluten sensitivity. His medication is costly and difficult to find, and because of his sudden bouts of nausea he has to be given cortisone. Two types of injection were previously available on the Egyptian market, but they are now no longer produced and replacements have yet to be found. Yahya now has to take a combination of two adult medicines in smaller doses for his child's body to tolerate. He suffers from malnutrition and lack of calcium, and he has barely been well in his short life up to now. “Cortisone just treats the symptoms. It does not deal with the real condition. The only way for that to happen is for a patient to stop eating products containing gluten,” Al-Guindi says. Since gluten is a main component of wheat, it can be difficult to plan menus that exclude gluten. Such menus can also be expensive, as gluten-free products are not medicines subsidised by the government. Having to look out for appropriate food items is one of the difficulties his mother faces in Egypt, particularly since there are only a few outlets which sell foodstuffs that are gluten-free and suitable for people with gluten-sensitivity and most of them are expensive. One kilo of gluten-free refined flour can cost as much as LE57, for example; a 400-gram pack of gluten-free pasta can cost as much as LE24 and bread flour can cost LE30 a kilo. Since these are main constituents of any diet, they can be difficult to maintain on a daily basis, never mind a lifetime. Al-Guindi says that there is an outlet for gluten-free foods at the Institute for Food Technology, linked to the Centre for Agricultural Research in Dokki, which sells gluten-free foods. Up to 300 people currently use the centre. In the meantime, Ikram has to work out Yahya's daily menu, and Yahya has to keep his appetite in check because his disorder can be hard to deal with.
