Disorders of the Gastrointestinal System, 2nd Edition
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improvement within days of eliminating gluten from their diets. However, up to 5% of people experience symptoms even after a gluten-free diet has been initiated. This is usually because of small amounts of unintended gluten in the diet from hid- den foods or products (Ciclitira, 2021). About 1%–2% of people with celiac dis- ease never fully heal after eliminating glu- ten from their diet, a condition called re- fractory celiac disease (Malamut & Cellier, 2019). Here are some tips for patients as they adapt to their new way of eating, which must continue for the rest of their lives (National Institute of Diabetes and Diges- tive and Kidney Diseases, 2020): ● Read all food labels carefully. Many foods contain gluten in small or trace amounts. ● Ask pharmacists if prescribed medications contain wheat or other gluten products. ● Some nonfood products, such as lipstick, may contain gluten as an additive. Find out about the contents of any product that can be ingested via the GI tract. Contact the manufacturer for a product list of ingredients are not provided on the label or package insert. ● When dining at a restaurant, ask the server if a gluten-free menu is available or if the kitchen is safe from cross-contamination. Many restaurants with fryers and/or bakeries cannot guarantee safety, as other products are made with gluten in the facility on the same surfaces and with the same tools.
| NURSING CONSIDERATION
Because a gluten-free diet is a signif- icant dietary change, patients need dietary consults and comprehensive patient education. For example, be- cause many wheat products provide B vitamins, a multivitamin with B vi- tamins or a B vitamin complex may be recommended (Gluten Free Soci- ety, 2022). Gluten-free products have been somewhat of a fad diet that is not warranted unless a person is diag- nosed with celiac disease. Here are websites that patients with ce- liac disease may find useful: ● American Celiac Disease Alliance (http://www.americanceliac.org) ● American Dietetic Association (http://www.eatright.org) ● Celiac Disease Foundation (http://www.celiac.org) ● Gluten Intolerance Group of North America (http://www.gluten.net) ● National Foundation for Celiac Awareness (http://www.celiaccentral.org)
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