The autoimmune disease is triggered by the intake of gluten and rather than being an allergy or congenital condition, it usually develops over time and occurs in genetically predisposed people.

Symptoms include malabsorption, diarrhea, chronic unexplained abdominal pain and bloating, iron deficiency, and chronic fatigue.

Dr. Hassan Omran Odah, internal medicine, gastroenterology, and hepatology consultant at the International Medical Center network, told Arab News: “Gluten is not only present in foods and beverages but also cosmetic products such as lipsticks, oral and dental hygiene products, vitamins, and supplements as well as over-the-counter medication.”

Dr. Odah told Arab News that he believes the issue with high prices of GF products is related to food ingredients itself as gluten is present in most foods, and finding replacements can be difficult.

He said those most at risk of developing celiac disease were people with a family history of sufferers, making them more genetically susceptible.

As a genetic illness, celiac disease can be passed down from parents to their children and can affect all age groups. But while incurable, Odah pointed out that it could be managed by sticking to a strict gluten-free diet recommended by gastroenterologists and nutritionists.

He also noted that gluten restriction was necessary to prevent osteoporosis, malnutrition, lactose intolerance, and deficiencies in iron, vitamins B12 and D, and even small bowel cancer or lymphoma.

Gluten, Odah added, was present in most foods and the generally high price of gluten-free products was due to difficulties in finding affordable replacements. But alternatives do exist, such as replacing wheat flour with tapioca starch, corn, or rice flour, and substituting wheats and barely for quinoa, chickpea, or brown rice flour.

In 2019, the gluten-free market within the Gulf Cooperation Council union was worth $140 million, of which Saudi Arabia’s share amounted to 45 percent.

In 2018, the Kingdom’s Health Ministry launched a program to financially support the free provision of gluten-free foods to patients with celiac disease in its 33 hospitals and healthcare facilities in Riyadh, Madinah, Makkah, Jeddah, Taif, Al-Ahsa, Asir, Jazan, Qassim, Hail, Najran, and Baha.

Food replacements provided by the ministry’s hospitals include gluten-free breads, flour, cereal, biscuits, pastas, soups, and jellies.

Odah said patients needed to provide, “full medical reports including investigations that confirm the diagnosis such as serology, endoscopy findings, and biopsy results.”

The Celiac Association was established in 2018 under the patronage of Prince Faisal bin Bandar as a non-profit civil society, licensed by the Ministry of Human Resources and Social Development and supervised by the Ministry of Health, to serve gluten-free foods for all regions of the Kingdom.

Although tremendous efforts are being made to treat patients, Odah noted that more awareness initiatives were required.

He said: “We need more awareness of the disease in regard to its symptoms, diagnosis, and complications by doing more campaigns explaining the nature of celiac disease, especially since its symptoms are similar to other gastrointestinal disorders, and miss diagnosis is easy.”

Restaurants, cafes, and eateries throughout the Kingdom are becoming increasingly aware of the need to offer gluten-free dishes in order to accommodate all diners.