Gluten%20Free%20Diet

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Gluten Free Diet
Accommodating the Gluten Free Diet in The PCH
Setting
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What is Celiac Disease

• One of the most common inherited diseases
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• 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

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What Does the Intestinal Villi look like?

• The progression of damage to the villi

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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

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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

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Diagnosis

• Is difficult
• Misdiagnosis occurs
• Allergies
• Anemia
• Crohns Diease
• Diverticular Disease
• Chronic fatigue syndrome
• Irritable bowel syndrome
• Lactose intolerance
• Fibromyalgia
• Stress/depression/
• emotional disturbances
• Testing Antibody test, Small Intestinal Biopsy

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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

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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

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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

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Questions