What is celiac disease and what exactly is gluten?

According to Careum, celiac disease is an autoimmune disorder triggered by hypersensitivity to gluten. Gluten is the protein found in various types of grain, such as wheat, rye, and spelt. If a person suffering from celiac disease continues to eat foods containing gluten, this leads to a chronic inflammatory disease of the small intestine mucosa. As a result, the villi of the small intestine in particular undergo changes. This in turn can lead to malabsorption and even deficiencies.

Is coeliac disease a food intolerance?

Many people think that coeliac disease is a gluten intolerance. Coeliac disease is often interpreted as if it were ‘merely’ an intolerance to foods containing gluten. People are often unaware that there is a difference between coeliac disease and gluten intolerance. The condition known as ‘gluten intolerance’ does indeed exist. However, there are various terms; gluten intolerance is one of them.
To distinguish between coeliac disease and ‘intolerance’, the term non-coeliac gluten sensitivity (NCGS) is also frequently used. According to Sanitas, the term gluten intolerance is used when affected individuals experience symptoms such as bloating, diarrhoea, etc. after consuming gluten-containing
products, but it is not an autoimmune disease. Some people who suffer from NCGS
can tolerate a small amount of gluten.f the small intestine in particular undergo changes. This in turn can lead to malabsorption and even deficiencies.

In our view, the term ‘intolerance’ is far too broad. Many people, when they hear the term intolerance, think of lactose intolerance or a general food intolerance. However, if you compare lactose intolerance and coeliac disease, there is a significant difference. With lactose intolerance, it is possible to take medication if you know you are going to consume lactose. With lactose intolerance, you have too little lactase in your body – an enzyme that breaks down lactose and makes it digestible for the body.
Coeliac disease is much more complex, as it is an autoimmune disorder that can have serious consequences.

What is celiac disease and what exactly is gluten?

Coeliac disease runs in families and is therefore hereditary. If one member of the family is affected, the rest of the family is often tested as well. It is common for the condition to be diagnosed at a later stage. The diagnosis is made by means of a blood test. According to AHA.ch, the blood is tested for tissue transglutaminase IgA antibodies, endomysial IgA antibodies and total immunoglobulin A. However, a gastroscopy is often required to monitor the internal condition of the small intestine. During this procedure, tissue samples are taken to identify any changes, such as the breakdown of small intestinal villi.

What is celiac disease and what exactly is gluten?

There is currently no treatment. Those affected must avoid foods containing gluten for the rest of their lives. Foods to be strictly avoided include wheat, rye, barley, spelt, kamut, green spelt, emmer, triticale, einkorn and all foods made from them (e.g. bread, pastries, pasta, flour-based sauces, etc.).

There is gluten-free oats, meaning it is not contaminated with wheat, rye, barley or spelt and may therefore be eaten in small quantities by most people with the condition. However, there are some people who cannot tolerate gluten-free oats either, and blood test results may in some cases be positive even though a strict gluten-free diet has been followed. At the beginning, it is often very difficult for those affected to keep everything under control and remember everything. Especially in the early stages, they do not know what they are allowed to eat and what they are not. A nutritionist could be a helpful option. This ensures that those affected are provided with all the necessary information to help them on their way.

Is a treatment for coeliac disease on the horizon?

Various research projects are currently underway worldwide to develop a drug for coeliac disease. We have taken a closer look at one of these projects and conducted extensive research on it. Since 2011, Professor Detlef Schupann, Director of the Institute for Translational Immunology at Mainz University Medical Centre, has been working with his team, in collaboration with Zedira, Darmstadt and Falk Pharma, Freiburg, on a drug candidate for the treatment of coeliac disease. The drug they have been researching since 2011 is called ‘Transglutaminase 2 Inhibitor ZED1227’.

The mechanism of action of this medicine is as follows: this medicine is designed to block the enzyme transglutaminase 2, thereby preventing the modified gluten from triggering the immune system. This inhibits inflammation of the intestinal mucosa and the overall immune response in those affected. However, this medicine is not intended to replace a gluten-free diet, but rather to protect those affected from symptoms such as intestinal damage or diarrhoea. Above all, it is intended to ensure a daily life with fewer worries. Patients should be able to eat out without worry, without having to fear suffering symptoms due to accidental contamination. This medication should be taken immediately before eating and, according to the study, should remain effective for several hours. It is therefore not an emergency medication, but is intended to act as a preventative measure.

According to the study, a trial involving this medicine was conducted in 2021 on patients with well-controlled coeliac disease to assess the extent to which the medicine can prevent the damage and symptoms caused by the ingestion of small amounts of gluten. The study results were very positive. In all patients who took part in the study, there was an improvement in the condition of the small intestinal villi and in small intestinal inflammation, in some cases even leading to normalisation of the mucosa. However, the study is not yet fully complete. Furthermore, the launch of a new global Phase 3 trial was planned for 2025. However, the Phase 3 trial has not yet been completed either.

Why are gluten-free products expensive?

We compared the ingredients of gluten-containing and gluten-free spaghetti on the Barilla website. The gluten-containing spaghetti contains just two ingredients: durum wheat semolina and water. The gluten-free spaghetti, on the other hand, is made from maize, yellow maize and brown wholegrain rice.
The situation is similar with Buitoni pizza doughs. In standard pizza dough, you’ll find only wheat flour, whereas the gluten-free dough contains various types of flour, i.e. starches: maize starch, rice flour, pea flour, vegetable fibres (potato, pea, rice, flax), millet flour, wholemeal flax flour and potato protein. (coop.ch 24.11.25). Just by looking at the ingredients, it is clear that the production of gluten-free foods is much more complex and labour-intensive than that of foods containing gluten. As more ingredients are used, raw material costs rise and, at the same time, production becomes more time-consuming.
As explained on the Schär website, rice and maize are often the main ingredients in gluten-free foods, but they are comparatively more expensive than wheat.

Unfortunately, there is also an economic reason why gluten-free products are more expensive than ordinary foods. The price of a gluten-free product generally depends on supply and demand. When comparing the gluten-free market with the conventional market for cereal products, the market for gluten-free foods is small. The high prices can be explained by the complex manufacturing process and strict quality controls. According to Schär, the strict quality assurance systems are in place to ensure a high level of product safety during delivery, production and packaging. The raw materials and finished products must be constantly tested for their gluten content and other allergens.

As explained in the previous section, another reason for the high prices is the significantly smaller target market. Currently, coeliac disease is becoming increasingly well-known; despite this, there are only a few people who have to follow a strict gluten-free diet. In Switzerland, around 1 in 100 people are affected by coeliac disease. With a population of around 9 million, there are approximately 90,000 people across Switzerland who suffer from coeliac disease. It is well known that large companies tend to focus on turnover, and due to the smaller target group, most companies lose interest in investing in the gluten-free market. According to our research, the smaller target group, complex production processes, more expensive ingredients and the wide variety of ingredients are the main reasons why gluten-free products are so expensive.

What apps are available?

Nowadays, there are many different apps designed to support people with coeliac disease in their daily lives. Although these apps vary in type and functionality, they all share the same goal: to make everyday life easier for those affected and to give them greater peace of mind when shopping, cooking and eating. Precisely because gluten is often found in products where you wouldn’t expect it, such apps help to reduce uncertainty and identify where gluten is present and where it isn’t.

Scanner apps are currently particularly popular and widespread. These allow users to scan the barcodes of food products using their mobile phone camera or enter them manually. Within seconds, the app tells you whether the scanned food contains gluten or not. This type of app is particularly helpful when shopping, as some people often find it difficult to read the ingredients list. This is especially true because gluten is frequently hidden in food additives. A well-known example of such an app is the ‘GF-Scanner’.

However, there are also apps that use location data to show those affected suitable dining options, such as restaurants, hotels or cafés in the vicinity. Some of these apps have a built-in navigation system that directly shows the route to the chosen destination. This makes it easier to go out for a spontaneous meal, particularly in a new city or a foreign country.

The ‘Find Me Gluten Free’ app is one of the favourites. There are also travel apps that specifically recommend gluten-free holiday destinations. The aim here is to make travel planning easier for those affected, without them having to worry about where they can eat. In addition to this feature, there are apps that have a built-in translation system. This allows requests to kitchen staff to be translated into various languages. This makes it easier to order gluten-free meals abroad. The ‘DZG-APP’ has a translation programme that supports many languages.

Furthermore, there are apps that offer a wide selection of gluten-free recipes and make it easier to cook gluten-free meals. They serve not only as inspiration but also help those affected to prepare varied and balanced meals. Many of these apps include step-by-step instructions and nutritional information. In addition, many apps allow you to save recipes or create shopping lists. This makes meal planning easier and ensures that those affected know they are consuming gluten-free foods. Such apps are a valuable source of support and guidance, particularly for people who have only recently switched to a gluten-free diet. You can find many delicious recipes on the ‘Gluten Snap’ app.

How reliable are apps?

According to the National Celiac Association (NCA), these apps are a helpful aid in everyday life but are no substitute for carefully reading the ingredients list. People with coeliac disease are strongly advised to learn how to read the ingredients list correctly and to practise doing so regularly. After all, even the best app cannot provide a 100% guarantee.

Errors can occur particularly quickly with scanner apps, as not all foods are always recorded in the database and therefore no reliable information about the product can be provided. It should also be noted that some apps still display outdated information or do not correctly identify certain additives. Furthermore, manufacturers may change the ingredients or composition of their products at any time. However, these changes are not immediately recorded by every app, which can lead to confusion between old and new products.

It is therefore important to update the apps regularly and not to rely solely on the information provided by the app. In case of doubt, the manufacturer should be contacted directly. This is best done by telephone or email to obtain a reliable answer straight away.

We tested the ‘GF-Scanner’ and unfortunately found that error messages occurred quite frequently. Either the app could not find the product
in the database, or you had to manually enter the rest of the ingredients into the app.

Is labelling mandatory?

According to Rosenfluh.ch, the Ordinance of the Federal Department of Home Affairs (EDI) on the labelling and advertising of foodstuffs, and in accordance with Directive 2003/89/EC, which applies in all EU Member States, all foodstuffs in Switzerland and the EU must clearly state which allergenic ingredients they contain. Cereals containing gluten, such as wheat, rye and/or barley, must always be listed and must always be printed in bold on the list of ingredients. In Switzerland, there is also a requirement to label accidental mixtures. This rule is set out in the LKV.
As this rule applies only in Switzerland and not in the EU, products from the EU may only be sold in Switzerland if the list of ingredients has been amended.

What is meant by ‘unintentional mixing’?

Accidental mixing occurs when the gluten content of a ready-to-eat food product exceeds, or could exceed, 200 mg per kilogram. If a product contains more than 20 mg of gluten per 100 g, this must be clearly indicated on the list of ingredients with the statement ‘May contain traces of gluten’. Accidental mixing occurs when both gluten-containing and gluten-free foods are produced or stored in the same facility. This can lead to contamination.

Does the health insurance fund cover any of the additional costs?

No, compulsory health insurance only covers dietary supplements and medicines from the pharmacy and therefore does not cover the additional costs of the more expensive foods. This can have serious health consequences, particularly for children, as the only ‘treatment option’ is a strict gluten-free diet. If those affected do not (or cannot) adhere to this, it can cause severe damage to the gut and trigger growth disorders and/or deficiency symptoms. Furthermore, neglecting the diet increases the risk of secondary conditions, as the body can no longer absorb the necessary nutrients and vitamins sufficiently. These nutrients are particularly important during childhood and adolescence to ensure full development.

To offset the additional costs at least to some extent, certain deductions can be claimed on your tax return. However, the rules governing these deductions vary from canton to canton. In the cantons of Fribourg, Bern, Lucerne, St. Gallen and Zurich, for example, there is a flat-rate deduction of 2,500 Swiss francs. In the canton of Fribourg, it is also necessary to submit a valid medical certificate in order to claim the tax deductions at all. Those affected should therefore ensure they are fully informed about the requirements that apply in their canton.

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