Long‐term care for patients with coeliac disease in the <scp>UK</scp>: a review of the literature and future directions

Kurien, Matthew; Trott, Nick; Sanders, David S.

doi:10.1111/jhn.12379

Cited by 28 publications

(28 citation statements)

References 51 publications

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“…Individuals expressed a desire for more information regarding potential weight change after commencing the GFD. This is in line with previous research, which highlights the value of dietician-led services and the desire for more dietetic support in individuals with CD (33,34) . Furthermore, disordered eaters discussed distress surrounding weight changes at CD diagnosis.…”

Section: Discussionsupporting

confidence: 91%

Disordered eating patterns in coeliac disease: a framework analysis

Satherley

Higgs

Howard

2017

J Human Nutrition Diet

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Coeliac disease has a varied impact on eating patterns. The need to follow a gluten-free diet and to be vigilant around food has to be balanced with concerns around food availability and cross-contamination which have the potential to contribute towards disordered eating attitudes and behaviours. The findings suggest that the theoretical model of disordered eating provides an adequate explanation of disordered eating patterns in coeliac disease.

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Section: Discussionsupporting

confidence: 91%

Disordered eating patterns in coeliac disease: a framework analysis

Satherley

Higgs

Howard

2017

J Human Nutrition Diet

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“…An assessment of GF dietary adherence by a dietitian is considered highly effective and is inclusive of assessing knowledge, behaviour while dining out, and intent to adhere (57,58) , indeed it is considered a gold standard by some authors (59,60) . Leffler et al (59) suggest that although serologic tests have very high sensitivities and specificities for the diagnosis of CD, they cannot replace dietitian evaluation in the assessment of GFD adherence.…”

Section: Methodological Challenges Of Assessing Dietary Adherencementioning

confidence: 99%

Identifying and improving adherence to the gluten-free diet in people with coeliac disease

2019

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Coeliac disease (CD) is an autoimmune gastrointestinal disorder whereby the ingestion of gluten, a storage protein found in wheat, barley and rye, causes damage to intestinal mucosa with resultant malabsorption, increased risk of anaemia and osteoporosis. Worldwide estimates suggest 1% of the population have CD. With no cure, the only treatment is a gluten-free diet (GFD). Adhering to a GFD can be very challenging; it requires knowledge, motivation and modified behaviours. Assessing adherence to a GFD is methodologically challenging. This review aims to provide an overview of the literature reporting adherence to a GFD in people with CD and the methodological challenges encountered. From six studies it has been reported that rates of adherence to a GFD range between 45 and 90% in patients of different ethnicities with CD. GF dietary adherence can be influenced by age at diagnosis, coexisting depression, symptoms on ingestion of gluten, nutrition counselling, knowledge of GF foods, understanding of food labels, cost and availability of GF foods, receiving GF foods on prescription and membership of a coeliac society. To date only five intervention studies in adults with CD have been undertaken to improve GF dietary adherence. These have included dietary and psychological counselling, and the use of online training programmes, apps, text messages and telephonic clinics. Future interventions should include people of all ethnicities, consider patient convenience and the cost-effectiveness for the healthcare environment.

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“…A duodenal biopsy is certainly the most accurate tool to verify a good histological response and thus to understand whether the patient is on a strict GFD (4)(5)(6) . However, a duodenal biopsy requires an upper gastrointestinal endoscopy, an expensive and theoretically hazardous procedure.…”

mentioning

confidence: 99%

Inadvertent and minimal gluten intake has a negligible role in the onset of symptoms in patients with coeliac disease on a gluten-free diet

et al. 2019

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Although the quantity of gluten that a well-instructed coeliac patient can involuntarily ingest is <10 mg of gluten/d which cannot induce significant villous damage, coeliac patients often attribute the origin of symptoms to the involuntary ingestion of trace quantities of gluten, either certain or hypothetical. Our aim was to evaluate whether the occurrence of symptoms in coeliac patients who histologically responded to a strict gluten-free diet was related to the involuntary consumption of minimal quantities of gluten. A case–control study to assess the association between gluten exposure and the occurrence of symptoms was designed. Between January 2017 and May 2018, coeliac patients attending our outpatient clinic were interviewed to detect the presence of symptoms. Based on a specifically designed form, patients were also divided into different risk groups of gluten exposure. A total of ninety-five coeliac patients on a strict gluten-free diet and with known histological recovery were enroled. Of them, fifty-two of them reported symptoms and they were enroled as cases; the remaining forty-three patients denied symptoms and were enroled as controls. Although this was not statistically significant, gluten exposure was more frequent in controls (Fisher’s exact test, P=0·07). Our results show no relationship between exposure to minimal quantities of gluten and onset of symptoms in coeliac patients. Symptoms are more frequent in patients who have no risk of gluten exposure. It is possible that the presence of these symptoms leads the patients to avoid situations that may place them at risk of gluten exposure.

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Long‐term care for patients with coeliac disease in the UK: a review of the literature and future directions

Cited by 28 publications

References 51 publications

Disordered eating patterns in coeliac disease: a framework analysis

Disordered eating patterns in coeliac disease: a framework analysis

Identifying and improving adherence to the gluten-free diet in people with coeliac disease

Inadvertent and minimal gluten intake has a negligible role in the onset of symptoms in patients with coeliac disease on a gluten-free diet

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