Transcript Slide 1
Gluten Free Diet Accommodating the Gluten Free Diet in The PCH Setting What is Celiac Disease • One of the most common inherited diseases – 1:133 • Chronic autoimmune intestinal disorder • Presentation of celiac disease is related to genetic, environmental and immunological factors • Can occur at any age • May be triggered by a gastrointestinal or viral infection, severe stress, surgery or pregnancy • Immunologic reaction to gluten • The absorptive surface of the small intestine becomes damaged What Does the Intestinal Villi look like? The progression of damage to the villi Effects of Celiac Disease Results in malabsorption: • Iron, calcium and folate • Carbohydrate – especially lactose • Vitamins – A, D, E, K • Protein Vitamin and mineral deficiencies resulting in: •Anemia •Osteoporosis •Neurological disorders – ataxia, seizures and neuropathy Increased risk of developing other autoimmune disorders •Thyroid disease •Type I diabetes •Gastrointestinal cancers Symptoms • Abdominal pain, bloating and gas • Indigestion/reflux • Nausea and vomiting • Diarrhea, constipation • Lactose intolerance • Weight loss – note that CD can also occur in obese individuals • Chronic fatigue and weakness • • • • • • Bone and joint pain Easy bruising of the skin Edema of hands and feet Migraine headaches Depression Mouth ulcers Diagnosis • Is difficult • Misdiagnosis occurs: • Allergies • Anemia • Crohn’s Diease • Diverticular Disease • Chronic fatigue syndrome • Irritable bowel syndrome • Lactose intolerance • Fibromyalgia • Stress/depression/ emotional disturbances Testing: Antibody test, Small Intestinal Biopsy Treatment Diet, diet, diet… for life: Grain Group most affected •Dairy, fruits, vegetables and protein group food groups have minimal changes •Emphasis on whole foods, not processed or modified •Many naturally gluten-free foods Treatment – Strict Gluten Free Diet for Life Avoid wheat, barley and rye Avoid oats Hidden ingredients: •Sauces •Marinades •Gravies •Salad dressings •Soups •Prepared meats – hamburger patties, deli meats, hot dogs •Candy •Flavoured coffees and teas Barriers and Solutions • Cross Contamination » Guidelines to manage same • Cost and Variety » “RDF Emergency Pack” » Supplier sources • Staff Knowledge » Educational resources • Diet adequacy » Individualized nutrition care plan • Lack of preparation for residents » Inform sites of potential residents on gluten free diets Questions