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If you have celiac disease or gluten intolerance, it’s important to be able to read food labels carefully to make sure that the foods you’re eating are gluten free:

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Eating out - Coeliac UK

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Bite Size: Reading Food Labels - Webinars on Coeliac Disease - patientwebinars.co.uk

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All you need to know about gluten free and the law:

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With a prevalence of one in 100, hundreds of thousands of people in the UK have coeliac disease. But there are half a million who don't know it and may still be struggling with unexplained symptoms. Could you be one of them? Read on to find out more about coeliac disease, or go straight to our online assessment to check your symptoms.

What is coeliac disease?

Coeliac disease (pronounced see-liac and spelled celiac in other countries) is a serious illness where the body's immune system attacks its own tissues when you eat gluten. This causes damage to the lining of the gut and means the body can't properly absorb nutrients from food. Coeliac disease is not an allergy or food intolerance.

How common is it?

Coeliac disease is common and affects one in 100 people. However only 30% who have the condition have been diagnosed which means there are currently nearly half a million people who have coeliac disease but don't yet know.

If a first degree family member (such as mother, father, sister or brother) has the condition then the chances of having it increase to one in ten.

Did you know?

Research is currently underway to find out more about the genes behind coeliac disease and how more knowledge could help us stop the condition in its tracks. Read more in our research section.

How to know if you have coeliac disease

Check your symptoms

Coeliac disease has a wide range of symptoms so check below or complete our online assessment.

GI symptoms

Symptoms range from mild to severe, and can include bloating, diarrhoea, nausea, wind, constipation, tiredness, mouth ulcers, sudden or unexpected weight loss (but not in all cases), and anaemia.

"I suffered with terrible tummy problems before I was diagnosed. My stomach was crampy and painful every time I ate and I was so bloated I looked six months pregnant."

IBS

Because of the way that coeliac disease can affect the gut, it's frequently misdiagnosed as IBS.

Other symptoms

If you think you could have coeliac disease, take our online assessment at isitcoeliacdisease.org.uk.

To help you understand coeliac disease and the steps involved in diagnosis, we have developed a short animation to explain the symptoms, diagnosis and treatment. It is available in English, Welsh, Arabic, Bengali, Polish, Punjabi and Urdu.

What is the treatment for coeliac disease?

Once diagnosed, the only treatment for coeliac disease is a gluten free diet. Gluten is found in wheat, barley and rye. Some people are also sensitive to oats. Once gluten is removed from the diet, you should start to feel much better.

What is dermatitis herpetiformis?

Dermatitis herpetiformis (DH) is the skin manifestation of coeliac disease which occurs as a rash that commonly occurs on the elbows, knees, shoulders, buttocks and face, with red, raised patches often with blisters. It affects around one in 3,300 people.

If you think you have DH you may be referred to a dermatologist as well as for a gut biopsy. While waiting for the gluten free diet to take effect, you could be prescribed medication like Dapsone to keep the rash under control.

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With a prevalence of one in 100, hundreds of thousands of people in the UK have coeliac disease. But there are half a million who don't know it and may still be struggling with unexplained symptoms. Could you be one of them?

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Coeliac disease - NHS (www.nhs.uk)

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Coeliac disease is a condition where your immune system attacks your own tissues when you eat gluten. This damages your gut (small intestine) so your body cannot properly take in nutrients.
Coeliac disease can cause a range of symptoms, including diarrhoea, abdominal pain and bloating.

Coeliac disease is caused by an adverse reaction to gluten, which is a dietary protein found in 3 types of cereal:

Gluten is found in any food that contains those cereals, including:

pasta

cakes

breakfast cereals

most types of bread

certain types of sauces

some ready meals

In addition, most beers are made with barley.

Symptoms of coeliac disease

Eating foods that contain gluten can trigger a range of gut symptoms, such as:

Coeliac disease can also cause more general symptoms, including:

Children with coeliac disease may not grow at the expected rate and may have delayed puberty.

What causes coeliac disease?

Coeliac disease is an autoimmune condition. This is where the immune system (the body's defence against infection) mistakenly attacks healthy tissue.

In coeliac disease, the immune system mistakes substances found inside gluten as a threat to the body and attacks them.

This damages the surface of the small bowel (intestines), disrupting the body's ability to take in nutrients from food.

It's not entirely clear what causes the immune system to act this way, but a combination of genetics and the environment appear to play a part.

Treating coeliac disease

There's no cure for coeliac disease, but following a gluten-free diet should help control symptoms and prevent the long-term complications of the condition.

Even if you have mild symptoms, changing your diet is still recommended because continuing to eat gluten can lead to serious complications. This may also be the case if tests show that you have some degree of coeliac disease even if you do not have noticeable symptoms.

It's important to ensure that your gluten-free diet is healthy and balanced.

An increase in the range of available gluten-free foods in recent years has made it possible to eat both a healthy and varied gluten-free diet.

Complications of coeliac disease

Complications of coeliac disease only tend to affect people who continue to eat gluten, or those who have not yet been diagnosed with the condition, which can be a common problem in milder cases.

Potential long-term complications include:

Less common and more serious complications include some types of cancers, such as bowel cancer, and problems affecting pregnancy, such as your baby having a low birth weight.

Find out more about the complications of coeliac disease.

Who's affected

Coeliac disease is a condition that affects at least 1 in every 100 people in the UK.

But some experts think this may be underestimated because milder cases may go undiagnosed or be misdiagnosed as other digestive conditions, such as irritable bowel syndrome (IBS).

Reported cases of coeliac disease are higher in women than men.

It can develop at any age.

People with certain conditions, including type 1 diabetes, autoimmune thyroid disease, Down's syndrome and Turner syndrome, have an increased risk of getting coeliac disease.

First-degree relatives (parents, brothers, sisters and children) of people with coeliac disease are also at increased risk of developing the condition.

Diagnosing coeliac disease

Routine testing for coeliac disease is not done in England.

Testing is usually only recommended for people who have symptoms, or who have an increased risk of developing coeliac disease, such as those with a family history of the condition.

First-degree relatives of people with coeliac disease should be tested.

Read about diagnosing coeliac disease for more information about when testing for coeliac disease should be done.

Help and support

Coeliac UK is a UK charity for people with coeliac disease.

Its website has useful resources, including information about a gluten-free diet, local groups, volunteering and ongoing campaigns.

You can also call the Coeliac UK helpline 0333 332 2033, open Monday to Friday from 10am to 4pm.

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Find out about coeliac disease, an autoimmune disease affecting the digestive system that makes a person have an adverse reaction to gluten.

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Bite Size: What is Coeliac Disease? - Webinars on Coeliac Disease - patientwebinars.co.uk

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If you have coeliac disease you will have to avoid gluten for life.

A gluten free diet is the only treatment for the condition.

Gluten is found in the grains wheat, barley and rye.

On the gluten free diet you can eat many foods including meat, fish, fruit, vegetables, rice and potatoes.

You can also eat gluten free substitute foods and processed foods that don't contain gluten.

You can tell whether gluten is in a food by learning about allergen labelling - it sounds scary, but you get used to it once you know how.

If you have been medically diagnosed with coeliac disease then your immune system has been reacting to gluten and damaging your gut. To get better, you must remove gluten from your diet, which is the only treatment for coeliac disease. Gluten is found in the grains wheat, barley and rye.

You may have heard the term 'gluten free diet' before. This can be a bit confusing to some people because it isn't a diet in the way that most people understand it - it's not designed to help people lose weight. It's just a way of eating that helps you heal your gut so you can start absorbing all the nutrients you need from your diet.

Here we briefly discuss some of the facts about a gluten free diet so you have the knowledge you need to change your diet after your diagnosis. To help you further, you could join us and become a member of Coeliac UK to gain access to recipes and a database of food products which have all been checked for being eaten on a gluten free diet - great tools to get you started. The best support comes from people who understand. We can help you make safe food choices more easily and connect with others just like you, because we know what it takes to live gluten free every day.

Join us today to get instant access to the support and resources that will help you live well, gluten free every day.

Food

On the gluten free diet you can eat any naturally gluten free foods, such as:

You can also eat processed foods which don't contain gluten, such as ready meals and soups. Our Food and Drink Information lists thousands of products and you can access this online, on our app or order one in hard copy. Some ingredients are confusing as they can be made from wheat but the final ingredient is gluten free, for example glucose syrup. Read more about information on labels and ingredients like this.

Some people can't tolerate oats as they contain a protein called avenin. You can read more about oats here.

Our Gluten free Checklist can help you identify which foods are safe - you can download a copy at the bottom of this page. This is a great tool to get you started. And to help you shop, use our Coeliac UK Live Well Gluten Free app which will let you scan items to tell you whether we list these as gluten free.

There are also gluten free substitute foods available, such as specially made gluten free bread, flour, pasta, crackers and biscuits. These are available in the free from section of the supermarket and health food stores. Gluten free bread and flour mixes are also available on prescription for some people.

Drinks

There are plenty of both alcoholic and soft drinks which don't contain gluten:
Find out more on alcohol
There are also specially made gluten free beers and lagers available.

The following drinks are NOT suitable for people with coeliac disease:

This information is based on the advice of our Food Standards Committee, Health Advisory Council and/or the Prolamin Working Group.
Find out more about how gluten free beer is made
Feeling better

After your diagnosis of coeliac disease and moving to a gluten free diet you will start to feel better as your gut heals.

Some people feel significantly better within a few days of cutting out gluten but some people may see more of a gradual improvement in their symptoms or that one symptom improves before another.

It can take between six months and up to five years (in some cases longer) for the gut damage caused by eating gluten to fully heal. Several factors are thought to be involved in the variable time taken for the gut to heal, including age and severity of gut damage at diagnosis.

If your symptoms have not improved or have become worse since starting a gluten free diet, speak to your GP, dietitian and/or gastroenterologist who are best placed to monitor your response to the gluten free diet.

If you make a mistake

Following a gluten free diet is a learning process, not only for you but also for your family and friends. Mistakes can happen, especially if you have only recently been diagnosed.

If you have coeliac disease and eat gluten by mistake, you would usually start to have symptoms a few hours after eating it and the symptoms can last from a few hours to several days. The effects vary from person to person and depend on how much gluten you've eaten, how sensitive you are and how long you have been on a gluten free diet.

If you make the occasional mistake and eat gluten by accident, it's unlikely to cause lasting gut damage. It's a learning process and we can support you and help you because we understand what you are going through. Our Helpline is staffed with dietitians and food experts who are here to help you with advice and support, so call us today on 0333 332 2033. We're here to help.

What to do if you have symptoms

If you have diarrhoea or you are vomiting, it's important to keep yourself well hydrated by drinking lots of water.

Some people find that taking medication to treat constipation, diarrhoea or headaches can ease symptoms, but check with your pharmacist or GP.

The most important thing is to get back onto your gluten free diet to try to prevent further symptoms.

If your symptoms are very severe or do not improve, speak to your GP.

Coeliac UK support gluten free food safety for people with coeliac disease and gluten related conditions.
Find out more

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The gluten free diet - All you need to know about the diet that will make you well again

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All you need to know about the gluten free diet.

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Update - About coeliac disease EXPLAINED

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NHS Tayside (scot.nhs.uk)

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NHS Tayside Adult Coeliac Disease Diagnosis and Treatment Pathway

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Overview | Coeliac disease: recognition, assessment and management | Guidance | NICE

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Evidence-based recommendations on the recognition, assessment and management of coeliac disease in children, young people and adults.

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Coeliac Disease: an underdiagnosed condition that is on the rise worldwide

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Cristian Costas Batlle looks at the challenges of getting accurate diagnosis figures for this growing condition.

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Yvonne Jeanes is an academic dietitian, her research focus is on coeliac disease and the practicalities of living gluten free. She is on Twitter: @DrYJeanes.

Nick Trott is a gastroenterology dietitian who helps manage the dietetic-led coeliac clinic at the Royal Hallamshire Hospital in Sheffield. His research and clinical interests include disorders of gut brain interaction, IBD, and gluten-related disorders. He is on Twitter: @trott_nick.

Cristian Costas Batlle is a gastroenterology dietitian running the dietetic-led coeliac service at Bradford Teaching Hospitals NHS Foundation Trust and his clinical interests mainly include coeliac disease, IBS, and IBD. He is on Twitter: @cristiancostasb.

I n response to COVID-19 the British Society of Gastroenterology (BSG) have released interim guidelines ¹ supporting the non-biopsy diagnosis of coeliac disease - under specific conditions.

These guidelines will streamline the diagnosis of coeliac disease for many patients and negate the need to undertake an invasive duodenal biopsy. However, with the inevitable move from secondary to primary care diagnosis of coeliac disease, it is important that patients with coeliac disease continue to receive appropriate support and management.

Coeliac disease is a chronic immune-mediated enteropathy triggered by gluten ingestion in genetically susceptible individuals. Coeliac disease increases the prevalence of vitamin and mineral deficiencies, osteoporosis, other autoimmune disorders, and gastrointestinal malignancies.

Historically, diagnosis has been achieved through a case finding approach. Where there is clinical suspicion, screening serology (endomysial and tissue transglutaminase antibodies) is undertaken and diagnosis is confirmed via duodenal biopsy in secondary care. ²

There has been a four-fold increase in the incidence rate in the UK between 1990 and 2011 (from 5.2 to 19.1 per 100 000 person years). However, 75% of sufferers remain undiagnosed. ³

The cornerstone of treatment for coeliac disease is a gluten-free (GF) diet. National Institute for Health and Care Excellence (NICE) guidelines on the management of the condition highlight that dietitians are pivotal in improving patient knowledge and supporting behaviour change required to successfully adhere to the GF diet. ⁴

Adherence to a GF diet is widely recognised to be challenging; even a small quantity of gluten inadvertently ingested can cause symptoms and inflammation.

NICE quality standard states 'Healthcare professionals (such as consultants or GPs) [should] ensure that people newly diagnosed with coeliac disease discuss how to follow a gluten free diet with a healthcare professional with specialist knowledge of coeliac disease, such as a dietitian', and this is the treatment modality preferred by patients. ⁴

Dietitians play an important role in coeliac disease management; they explain the diagnosis in detail and work with patients to educate them and reduce the psychological burden of living GF. Dietitians also navigate the numerous practicalities associated with dietary adherence.

Dietitians will often address the following within their consultations:

* rationale for GF diet and what constitutes a nutritionally adequate GF diet;
* practicalities of living GF, inclusive of food shopping, label reading, eating away from home, and consideration of cross contamination risk;
* readiness/acceptance of diagnosis, family support, and any barriers to adhering to the GF diet, such as financial constraints; and
* consideration of other comorbidities (such as, diabetes, obesity, IBS, and/or disordered eating).

Initial contact with a dietitian after diagnosis is either a one-to-one consultation or in a group session with a follow-up one-to-one, either in person or via a virtual clinic.

Group sessions have shown comparable outcomes to one-to-one consultations, with the additional benefit of peer support ⁵ and of relevance to current times telephone clinics have also been shown to improve GF dietary adherence. ⁶

During follow-up appointments, through a detailed assessment, dietitians can detect inadvertent gluten ingestion, enabling patients to adhere to the, often challenging, lifelong GF diet.

Over the past year we have entered a period of rapid change in how health care is delivered. The diagnostic pathway for coeliac disease is moving towards primary care, with benefits to patients and the health service.

The challenge now is to ensure a similar pace of change in the management of coeliac disease, enabling patients to have access to dietitians to optimise their treatment; the GF diet. Dietitians are experts who enable patients to adhere to a GF diet and sustain nutritional adequacy while at the same time reducing dietary burden.

Below is a selection of free and paid resources we recommend patients are signposted to before their dietetic appointment. It is important to remember they are generic and cannot replace dietetic education and support where nutritional information on the GF diet is individualised to patients' specific needs.
Free resources:
The Coeliac UK website: the 'New digital resource to support you after diagnosis' section includes videos featuring a dietitian explaining the diagnosis and how to follow the GF diet. There are also many other useful free resources on the Coeliac UK Website.

The Patient Webinars website: the 'Overview: coeliac disease' section includes content created by dietitians with webinars, handouts, and frequently asked questions and answers to help people with coeliac disease.
Paid resources:
Coeliac UK Gluten Free Food Checker is an app that can help to identify gluten by scanning barcodes in supermarkets. It also has readily available online lists so people can search GF suitable foods on their phone without leaving the house.

Coeliac UK Gluten Free On The Move is an app that can help find accredited venues that offer GF food options all around the UK.

To access any of these apps patients will have to pay for a Coeliac UK membership. Currently a digital membership costs £1.25 per month and a full membership costs £2.25 per month (exemptions and discounts are also available). More information is available at: https://www.coeliac.org.uk/home.

This article is endorsed by the British Dietetic Association Gastroenterology Specialist Group.
References
1. Penny HA, Sanders DS, Gillett H, et al. BSG Interim Guidance: COVID-19 specific non-biopsy protocol for those with suspected coeliac disease. 2020. https://www.bsg.org.uk/covid-19-advice/covid-19-specific-non-biopsy-protocol-guidance-for-those-with-suspected-coeliac-disease (accessed 17 Feb 2021).
2. Ludvigsson JF, Bai JC, Biagi F, et al. Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology. Gut 2014; 63(8): 1210-1228.
3. West J, Fleming KM, Tata LJ, et al. Incidence and prevalence of celiac disease and dermatitis herpetiformis in the UK over two decades: population-based study. Am J Gastroenterol 2014; 109(5): 757-768.
4. National Institute for Health and Care Excellence. Coeliac disease: recognition, assessment and management. NG20. 2015. https://www.nice.org.uk/guidance/ng20 (accessed 17 Feb 2021).
5. Rej A, Trott N, Kurien M, et al. Is peer support in group clinics as effective as traditional individual appointments? The first study in patients with celiac disease. Clin Transl Gastroenterol 2020; 11(1): e00121.
6. Muhammad H, Reeves S, Ishaq S, Jeanes Y. Interventions to increase adherence to a gluten free diet in patients with coeliac disease: a scoping review. Gastrointest Disord 2020; 2: 318-326.

Featured photo by Wesual Click on Unsplash

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Non-biopsy diagnosis of coeliac disease: increased diagnosis and how dietitians can help

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Yvonne Jeanes is an academic dietitian, her research focus is on coeliac disease and the practicalities of living gluten free. She is on Twitter: @DrYJeanes. Nick Trott is a gastroenterology dietitian who helps manage the dietetic-led coeliac clinic at the Royal Hallamshire Hospital in Sheffield.

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Dermatitis herpetiformis, often referred to as 'DH', is a skin condition linked to coeliac disease.

DH affects fewer people than typical coeliac disease, at around one in 3,300 people. It can appear at any age, but is most commonly diagnosed in those aged between 50 and 69 years.

Symptoms

Typical symptoms are:

red, raised patches, often with blisters that burst with scratching

severe itching and often stinging.

The rash is most commonly seen on the elbows, knees and buttocks, but any area of the skin can be affected. The rash usually occurs symmetrically on the body, for example on both elbows.

Diagnosis

Diagnosis of DH is confirmed by a simple test called a skin biopsy.

A dermatologist will take a small sample of skin from an area without the rash. This is important because if the biopsy is taken from the area with the rash, it doesn't always give the right result.

This skin sample is checked to see if you have an antibody known as Immunoglobulin A (IgA).

If the antibody is found, the skin biopsy is positive and you should be referred to a gastroenterologist who will test you for coeliac disease using antibody blood tests and a gut biopsy.

At least 60% of people with DH do not have gut symptoms such as diarrhoea, constipation, stomach pain or bloating, most of them do have the same kind of gut damage that is seen with coeliac disease.

To make sure you get an accurate test result first time, it's important to keep eating gluten until you have the antibody blood tests and biopsy. If you have already taken gluten out of your diet, you must reintroduce gluten in more than one meal every day for at least six weeks before you have the tests.

Treatment

The treatment for DH is a lifelong gluten free diet. This means you will have to remove all sources of gluten, which is found in wheat, barley and rye, from your diet. Some people may also be sensitive to oats.

The time it takes for the skin rash to improve varies between people. Skin symptoms tend to take longer to recover compared to the typical gut symptoms associated with coeliac disease. It can take an average of two years for a gluten free diet to take full effect, and in some cases longer.

Drug treatment

As it can take a long time for a gluten free diet to take effect, you may also need drug treatment to help control the rash to begin with.

The most common drug prescribed for DH is dapsone. This is a tablet medication that needs to be swallowed, rather than a cream. Dapsone will help control the itching and development of blisters. It works within days, although the rash will come back if you stop taking it before the gluten free diet has taken effect.

It is important to find the lowest effective dose of the drug because there are side effects. The most common side effect is anaemia and your doctor may check for this on a regular basis. Less common side effects include headache, depression and damage to nerves, although this is rare.

DH should be monitored once the drug dose is reduced. Using medications such as dapsone will not make the gut damage seen in coeliac disease worse.

For those who cannot tolerate dapsone, there are two other drugs which also clear the rash - sulphapyridine and sulphamethoxypyridazine.

Drug treatment will only control the skin itching and blisters. It will not treat any other symptoms, so a gluten free diet is an essential part of the treatment of DH, as it is for anyone with coeliac disease.

Health risks

The same associated conditions and complications can occur in people with DH as in people with coeliac disease. These include osteoporosis, certain kinds of gut cancer and an increased risk of other autoimmune diseases such as Type 1 diabetes and thyroid disease.

As in typical coeliac disease, the risk of developing these complications is reduced if the gluten free diet is followed.

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Dermatitis herpetiformis, often referred to as 'DH', is a skin condition linked to coeliac disease.

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What is gluten and what ingredients have it?

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Bite Size: Gluten Free Diet - Webinars on Coeliac Disease - patientwebinars.co.uk

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Dermatitis herpetiformis symptoms and treatments

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Information on dermatitis herpetiformis, an autoimmune skin condition linked to coeliac disease.

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Tayside Gluten Free Food Service patient information leaflet

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Welcome to the new, alternative way of ordering your gluten free prescription. This service is currently only available for the Grampian/Highland/Tayside region.

Step 1

Fill in your details

It's quick and simple to do.

Step 2

Create your prescription

Add gluten free products to your online basket.

Step 3

Download your prescription

Print and take it to your local pharmacy.

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Scotland Gluten Free - Order your prescription online

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Welcome to the new, alternative way of ordering your gluten free prescription. This service is currently only available for the Grampian/Highland/Tayside region.

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Your GP is ultimately responsible for the clinical decision making about the amounts of gluten free staples that are prescribed and should take into account your nutritional needs.

What gluten free food is available on prescription will depend on the policy in your area. In England, this is set by your local Integrated Care Board (ICB), in Scotland and Wales by your Health Board and in Northern Ireland, by the Health and Social Care board.

Coeliac UK has helped develop the below National Prescribing Guidelines. Our recommendations outline how many units someone with coeliac disease should be able to access based on average nutritional needs for their age and sex. These are illustrative guidelines only and prescribers should take account of individual activity levels and nutritional requirements. For information on our recommendations for England, please see additional guidance further down the page.

Across the UK

England

In England, gluten free prescriptions are limited to bread and flour mixes only and some local areas may restrict further. For example, your local area may limit what is available based on your age or other qualifying factors like pregnancy. In some places, it has been withdrawn altogether and is available only on a case by case basis.

Scotland, Wales and Northern Ireland

In Scotland, Wales and Northern Ireland, anyone with a diagnosis of coeliac disease can access gluten free staple products such as bread, flour and pasta in line with National Prescribing Guidelines. How this is provided differs between the nations though. For example, in Scotland prescriptions are delivered through your pharmacy as part of the Scottish Gluten Free Food Service while if you live in Hywel Dda University Health Board, in Wales, there is a top up card scheme available. In all other eligible areas your GP can write a prescription for gluten free staple food which you can collect from your pharmacist, just like getting medicine on prescription.

The National Prescribing Guidelines

The National Prescribing Guidelines for gluten-free food were produced by a working group made up of NHS healthcare professionals, first launched in 2004 and are endorsed by Primary Care Society for Gastroenterology (PCSG) and the British Dietetic Association (BDA). They offer guidance on the amounts of gluten free food to be made available on prescription, per patient, per month, taking into account the average energy requirements for age and sex and other factors such as pregnancy or breast feeding.

The standards assume that patients with coeliac disease are also consuming naturally gluten free staples such as rice and potatoes and that the prescription does not meet entire nutritional needs alone.

These are illustrative guidelines only and prescribers should take account of individual nutritional requirements.

Number of units for different foods

The below table shows roughly how many units different foods equate to in table below. This gives flexibility about how you use your units so you can choose what's right for you. Remember only bread and flour is available in England.

Recommended amounts per month

These are illustrative guidelines only and prescribers should take account of individual nutritional requirements.

Additional guidance for England (bread and flour mixes only)

In England, only bread and flour mixes are available on prescription. Because of this, additional guidance based on national data on bread consumption in the UK is also available for prescribers in England.

Age and sex

Number of units

Female 19 years and older

8

Breastfeeding and 3rd trimester pregnancy

Refer to National Prescribing Guidelines (Add 4 units for breastfeeding, add 1 unit for 3rd trimester pregnancy)

Additional consideration for prescribers

Prescribers should use their clinical judgement and take energy requirements into account when deciding on appropriate quantities to prescribe. They should seek advice from a dietitian if they are unsure.

Our Helpline is always happy to help with any enquiries you may have on gluten free prescribing: call them on 0333 332 2033 Mon-Fri 10am-4pm

How the guidelines were calculated

The above units are calculated according to established average energy requirements for age and sex and draws on consumption data from the National Diet and Nutrition Surveys. It assumes that individuals will be getting additional carbohydrates from rice and potatoes alongside staple products. In the case of England specific recommendations this is based on energy requirements for bread and flour only.
Basis of the guidelines:​

Average energy requirements based on age and sex ( Scientific Advisory Committee on Nutrition (SCAN) Dietary Reference Values for Energy 2011 )

Dietary recommendations for balanced eating (Scientific Advisory Committee on Nutrition (SCAN) on carbohydrates and health 2015)

Review of consumption data from National Diet and Nutrition Surveys (Whitton et al, 2011)

It is also assumed that people with coeliac disease don't just eat substitute products but also eat rice and potatoes

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Understand more about what gluten free food you can have on prescription if you are diagnosed with coeliac disease.

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Bite Size: Cross Contamination - Webinars on Coeliac Disease - patientwebinars.co.uk

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Scottish Coeliacs | Facebook

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Welcome to our page for Scottish Coeliacs. We can discuss, share and pass on information about eating gluten free in Scotland and as a result hopefully improve everyones gluten free experience in…

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Bite Size: Calcium Requirements - Webinars on Coeliac Disease - patientwebinars.co.uk

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Bite Size: Tips for Eating Out & Whilst on Holiday - Webinars on Coeliac Disease - patientwebinars.co.uk

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Welcome to 100 things I wish I'd known about being gluten free - a podcast brought to you by Coeliac UK. In this podcast series, we'll explore a vast array of topics related to living well gluten free. From getting a diagnosis of coeliac disease to the latest advancements in medical research, dining out safely, managing the gluten free diet, travelling abroad and so much more.

Podcasts - Coeliac UK

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Travel guides - Travelling gluten free needn't be a hassle - Coeliac UK

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Travel guides - Travelling gluten free needn’t be a hassle

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Having coeliac disease shouldn’t stop you from travelling. Jet off on holiday with the knowledge from Coeliac UK to help you manage your gluten diet while you’re away.

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Bite Size: Can I eat oats? - Webinars on Coeliac Disease - patientwebinars.co.uk

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Becky Excell’s How to Bake Anything Gluten Free