9.4.1.1 Coeliac disease

Gluten-free

Some gluten-free breads and food mixes can be prescribed on an FP10 for gluten-sensitive enteropathies including steatorrhoea due to gluten-sensitivity, coeliac disease and dermatitis herpetiformis. Prescriptions must be endorsed ACBS.

The diagnosis of coeliac disease is increasing. The gold standard for making the diagnosis is duodenal biopsy as blood tests may give false positives. However, false negatives are rare so blood tests may be a useful screening test. Gluten should not be withdrawn prior to a biopsy or blood test. Refer to gastroenterologist or specialist dietician led coeliac clinic for further advice.

In addition to gluten-free food, patients should eat natural carbohydrate foods such as rice and potatoes. Gluten-free substitute foods should only provide 15% of the total energy required. Further information can be found on the NHS Website Eatwell Guide.

In England, only bread and flour mixes are available on prescription.

NHS England Guidance for CCGs: Prescribing Gluten-Free Foods in Primary Care (November 2018)

Commissioners in Devon have advised that GPs should not prescribe gluten-free products for patients aged 18 years and over.

Patients under 18 years of age are able to receive a limited range of gluten-free breads or food mixes only on prescription.

Guidance on the number of recommended personal units per month, based on national data on bread consumption in the UK, and the number of units in different gluten-free foods can be found in the tables below:

Recommended amounts per month:

AgeNumber of units per month

Child under 10 years

8

Child 11 - 18 years

12

Number of units for different foods:

Food itemNumber of units

400g bread

1

500g bread/flour mix

2

Gluten-free products

Patient information: NHS Health A-Z Coeliac disease

In order to ensure cost-efficient use of local NHS resources, the NHS Devon CCG Medicines Optimisation (MO) Team has prepared a list of locally recommended gluten-free products: Click here for preferred brands

Last updated: 15-12-2021

 

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