Diagnosis of Coeliac Disease & Gluten Free Sweet Pastry
Updated: Oct 18, 2020
Coeliac Awareness Week Post 5:
It is advised that a gluten-free diet should not begin until a diagnosis of CD has been confirmed by a health professional. Gluten should be included in the diet pre-diagnosis in order for symptoms to be displayed. (Gazzola (2015)
According to Coeliac Society of Ireland (2015b) states that any testing for CD is only accurate if the patient remains on a gluten containing diet before and during the testing process.
There are two main methods of diagnosis in Ireland are:
Blood test: Dennis & Leffler (2010) explains that the blood tests used to identify CD are looking for the antibodies: immunoglobulin A (IgA) or immunoglobulin G (IgG)
- The IgG blood test has a very high false positive rate, meaning that many people who have a positive result do not actually have coeliac disease.
Endoscopy and Biopsy: Green & Jones (2010) regard the endoscopy and biopsy as the gold standard for diagnosis of CD. Normally this procedure is only recommended if there is a history of CD in the family or if the blood tests come back positive. The endoscopy is medical procedure carried out by a gastroenterologist in which a flexible camera is passed down through the throat, stomach and into the small intestine where a small sample of tissue is removed (biopsy). A positive result in the biopsy is described as the presence of flattened villi (damaged). The villi have the responsibility in the body to absorb the nutrients from food.
After a confirmed diagnosis, and the implementation of a gluten free diet, there should be follow up biopsies performed in case of a misdiagnosis. The follow up biopsy will be looking for healed villi in the small intestine.
Gluten Free Sweet Pastry
Gluten Free Pastry for tarts is one of those things that I used to find endlessly frustrating until I found a few tricks that I'm sharing here.
Tin Size: 23cm fluted tart tin
Temperature: 170°C Fan
Cooking Time: 20-30 minutes
Chilling Time: 30 minutes
Ingredients:
230g Gluten Free Plain Flour (Dove's Farm)
7g Xanthan Gum
70g Caster Sugar
130g Cold Butter, diced
1 Egg Yolk
1 tbsp Cold water
Method:
In a stand mixer, with a paddle attachment, mix the flour, xanthan gum and caster sugar together.
Add the cold diced butter, continuing to mix with the paddle attachment until the mixture resembles fine breadcrumbs.
Mix the cold water with the egg yolk and add to the breadcrumb mix, mixing until comes together. There is no gluten to develop. If the dough isn't coming together, you can add a few more drops of water until dough forms.
Immediately after the dough comes together, roll the pastry out between two sheets of baking parchment larger than the tin you will be using. Chill for 30 minutes,
Preheat the fan oven to 170°C.
Lightly butter the tin. Peel off one of the sheets of baking parchment and use the side with the paper to help work the pastry into all the edges.
Remove the paper, trim the edges of the tart and put the baking parchment back on top for blind baking. (Use baking beans, rice or any dried pulses; dried pulses will smell weird)
Blind bake at 170°C for 15 minutes with the paper, remove the paper and bake for a further 10 minutes or until lightly golden.
Note: In my personal experience with gluten free pastry, it would often crack when chilled first and then rolled out. I find this method easier to work with.
References:
Gazzola, A. (2015) Coeliac Disease: what you need to know. (2nd ED) London: Sheldon Press
Coeliac Society of Ireland, 2015b. What is Coeliac Disease. [online] Available at: < www.coeliac-ireland.com/join-now/professional/prevalence-and-diagnosis/> [Accessed 20 February 2017]
Dennis, M. & Leffler, D.A. (2010) Real life with Celiac Disease: Troubleshooting and Thriving Gluten Free. United States: AGA Press
Green, P.H.R. & Jones, R. (2010) Celiac Disease: A hidden epidemic. New York: HarperCollins Publishers.