gluten free diet accommodating the gluten free diet in the pch setting
TRANSCRIPT
Gluten Free Diet
Accommodating the Gluten Free Diet inThe PCH Setting
• 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 is Celiac Disease
What Does the Intestinal Villi look like?
The progression of damage to the villi
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
Effects of Celiac Disease
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
• 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
Diagnosis
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
Avoid wheat, barley and ryeAvoid oats
Hidden ingredients:•Sauces•Marinades•Gravies•Salad dressings•Soups•Prepared meats – hamburger patties, deli meats, hot dogs•Candy•Flavoured coffees and teas
Treatment – Strict Gluten Free Diet for
Life
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