This blog will cover:
- What coeliac disease is
- How coeliac disease impacts people at work
- How to support employees with coeliac disease
What is coeliac disease?
The NHS describe coeliac disease as a condition where your immune system attacks your own tissues when you eat gluten. This happens because the immune system mistakenly identifies gluten as a threat to the body, and so attacks it. The impact damages the lining of the gut and means that the body can’t properly absorb nutrients from food.
1 in 100 people are thought to have coeliac disease in the UK – yet only 36% are diagnosed, meaning around 500,000 who have the disease aren’t aware of it.
As coeliac disease is caused by an adverse reaction to gluten, people with the condition should not eat any foods containing wheat, barley, or rye. Many of the foods we all eat in our day to day lives contain gluten (including bread, cereals, pasta, and cakes) but there are lots of great healthy and varied gluten-free alternatives available.
Eating foods that contain gluten when you have coeliac disease can cause a range of symptoms from mild to severe. They can vary from person to person, but common symptoms include diarrhoea, constipation, stomach aches, bloating and indigestion. People can also experience tiredness, unintentional weight loss, and fertility issues. If it goes undiagnosed and untreated it can lead to more severe complications.
There is no cure for coeliac disease, but by sticking to a gluten-free diet people with the condition can control symptoms and prevent any long-term complications. The NHS advises that even those with mild symptoms should change their diet, as eating gluten when you have coeliac disease can cause serious complications. These complications include iron deficiency, osteoporosis (weakening of the bones), and less commonly some types of cancer.
How can it impact people at work?
Dealing with the symptoms of any chronic illness can be difficult at work, especially as symptoms can vary from day to day. For example, on one day an employee with coeliac disease may feel fatigued, bloated or be suffering with diarrhoea, yet on another day they may feel completely fine. When an employee’s symptoms flare up it may mean they require a bit more time to complete tasks while they manage their symptoms.
Coeliac disease can also affect people socially at work. For example, colleagues may suggest going out for lunch but not consider whether the menu has gluten-free options, or someone may bring sweet treats into the office without realising they’re excluding a colleague with coeliac disease. This could cause the person to feel isolated and left out. Due to our physical health and mental health being closely linked, having a long-term illness can put you at higher risk of developing a mental health condition.
According to Mental Health Foundation, this can be brought on by things such as frustration, worry and stress that are experienced as a result due to things such as flare-ups and pain. A person may also experience social isolation, stigma and discrimination due to their condition.
What steps can employers take?
Encourage managers to have open conversations
Encourage managers to openly talk to their team members who have disclosed that they have coeliac disease. This is an opportunity for the staff member to talk about how they feel and how they are affected. They can raise any worries or concerns, and communicate how best they can be supported while at work.
Raise awareness and signpost to support
The fact that around 500,000 people in the UK are not yet diagnosed shows that there is a lack of awareness about this disease. Your internal wellbeing calendar and staff campaigns provide an opportunity to remind staff of the symptoms of coeliac disease and signpost them to support – such as Coeliac UK and this online self-assessment. Supportive information could be left in staff break-out areas, canteens, and posted on the intranet.
Educate managers on the disease and how they can support
You could also include awareness of long-term health conditions as part of your manager training. Managers are not expected to be health experts, but having an understanding of the impacts long-term illness can have could help them to support staff with things such as signposting or putting reasonable adjustments in place.
If you have occupational health in place, they can support with any reasonable adjustments or a return to work if a staff member as been off ill with a long-term condition. You can also signpost staff to an employee assistance programme (if you have on in place) for mental health support.
Access to bathroom breaks
As coeliac disease can cause both diarrhoea and constipation, employees with the condition may need to visit the bathroom more frequently and/or for longer periods of time. Employers should be considerate of this and make reasonable adjustments for staff to have access to bathroom breaks.
Considerations for areas such as the staff fridge and canteen
Employees with coeliac disease are restricted to what they can eat at work. There may be a limited amount of gluten-free options in the work canteen, and preparing lunch on surfaces in a work kitchen can be risky as there’s always the risk of contamination from other people’s food. Even a small amount of gluten can cause symptoms and long-term damage. Coeliac UK have included further information around cross-contamination.
Review what gluten-free options are available in your place of work, and ensure those with gluten-free dietary requirements still have access to meals – find information about gluten free foods here. Some staff may prefer to prepare their own lunch at home. Consider creating a ‘gluten-free safe space’ in the staff fridge to minimise any risk of cross-contamination.
When holding staff events or business lunches, consider what gluten-free options will be available.
If an employee is struggling to cope, suggest that they make an appointment with their GP if they haven’t already. Here they may be signposted to local support groups or offered help to manage physical symptoms or mental health struggles.
Summary
Coeliac disease is a common condition, yet more awareness is needed to ensure those with it are diagnosed so it can be managed effectively. Although there is no cure, there are things an employer can do to help support staff managing this long-term illness. This includes raising awareness, looking at reasonable adjustments and ensuring staff still have access to gluten-free options in work.
Further Support
Coeliac UK – Coeliac disease charity with a multitude of resources.
CIPD – Managing employees with long-term illnesses.
Guts Charity – Supportive resources on looking after our gut.
Mental Health Foundation – Long-term illness and mental health.
Sources:
www.nhs.uk/conditions/coeliac-disease/
http://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/long-term-physical-conditions-and-mental-health coeliac.org.nz/wp-content/uploads/2021/12/Living-Coeliac-Safe-in-the-Workplace-2021-Paths-Web-smaller.pdf
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