The mainstay of treatment for coeliac disease is a life long gluten free diet. This should (at least initially) be supervised by a dietician. Any identified deficiencies should be treated, however, with adherence to a gluten free diet, once corrected the replacements can be stopped. Once stabilised an annual check is sufficient, to monitor height and weight, review symptoms and consider the need for further dietary input.
Other considerations at annual review should include the need for DEXA scanning, the need for specific blood tests and the risk of long-term complications and co-morbidities.
Prescribing gluten free products
Gluten free products are available on FP10 and guidance has been issued on the prescribing of Advisory Committee on Borderline Substances (ACBS)- approved gluten-free foods. This guidance varies across the UK. In Wales the full guidance can be found here
It is likely that people will have become familiar with certain gluten free products. The all Wales guidance does not stipulate brand names but does however have products in “green” – freely prescribable, “amber” – on the advice of a dietician and “red” not normally prescribed. Furthermore there are recommended quantities to be prescribed per month.
The tables below are reproduced with the permission of the All Wales Medicine Strategy Group: