Reviewing a patient with coeliac disease

• Published in: BMJ 2012-01, Vol.344 (7843), p.46-47
• Main Authors: Berrill, James W, Ahmed, Haroon, Butt, Sohail, Swift, Gillian
• Format: Article
• Language: English
• Subjects: Anemia; Autoimmune diseases; Bone density; Bread; Breads; Celiac disease; Celiac Disease - blood; Celiac Disease - complications; Celiac Disease - diagnosis; Celiac Disease - diet therapy; Diabetes; Diet; Diet, Gluten-Free; Dietitians; Evidence-based medicine; Food products; Gastroenterology; Gastrointestinal diseases; Gluten; Gluten free diets; Gluten free foods; Hepatitis; Humans; Long-Term Care; Lymphoma; Medical referrals; Medical treatment; Osteochondrosis; Osteoporosis; Pasta; Patients; Pizza; PRACTICE; Primary care; Symptoms; Thyroid diseases; Thyroid gland
• ISSN: 0959-8138; 0959-8146; 1468-5833; 1756-1833
• DOI: 10.1136/bmj.d8152

Age group (years) Recommended number of units* Example of monthly prescription 1-3 10 6 × 400 g bread, 2 × 500 g pasta 4-6 11 6 × 400 g bread, 2 × 500 g pasta, 1 × (2 × 110-180 g pizza bases) 7-10 13 8 × 400 g bread, 2 × 500 g pasta, 1 × (2 × 110-180 g pizza bases) 11-14 15 8 × 400 g bread, 3 × 500 g pasta, 1 × (2 × 110-180 g pizza bases) 15-18 18 8 × 400 g bread, 4 × 500 g pasta, 2 × (2 × 110-180 g pizza bases) Men 19-59 18 8 × 400 g bread, 4 × 500 g pasta, 1 × (2 × 110-180 g pizza bases), 1 × 200 g crackers or crispbreads 60-74 16 8 × 400 g bread, 2 × 500 g pasta, 2 × 200 g crackers or crispbreads >=75 14 8 × 400 g bread, 2 × 500 g pasta, 2 × 200 g crackers or crispbreads Women 19-74 14 8 × 400 g bread, 2 × 500 g pasta, 2 × 200 g crackers/crispbreads >=75 12 6 × 400 g bread, 2 × 500 g pasta, 2 × 200 g crackers/crispbreads *For prescribing purposes, each prescribable gluten-free food is allocated a unit on the basis of its carbohydrate and energy content and its cost. [...]400 g bread = 1 unit; 500 g pasta = 2 units; two pizza bases (110-180 g each) = 1 unit; 200 g crackers or crispbreads = 1 unit. [...]of this increased prevalence and the consequent susceptibility to infection, England's Department of Health recommends offering pneumococcal vaccination to all patients, and some experts also suggest offering vaccines against haemophilus and influenza. First degree relatives have a 1 in 10 chance of being affected and should be assessed if symptoms develop.