Celiac Disease Follow-Up Checklists: Dietitian Commentary

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wheat image“Let food be thy medicine, and medicine be thy food”… Hippocrates has never been more accurate with this statement when it comes to celiac disease and non-celiac wheat sensitivity. Many people today (doctors included) feel that enough information is available online to learn how to follow the gluten-free diet; in fact, only 15% of patients have met with a dietitian within the first five years following a diagnosis1. However, as a disorder where the only treatment is the removal of a staple food group from the diet, world experts recommend that we should receive treatment from the professionals in our “medicine” – from dietitians.

Celiac Disease Foundation has created essential celiac disease management adult and pediatric checklists to guide you through the care you and/or your child need – and deserve – from doctors and dietitians. The dietary portions, adapted from expert recommendations by the Academy of Nutrition and Dietetics, provide you and your doctor an idea of what to expect from meeting with a dietitian.

View the complete Adult Celiac Disease Follow-Up Checklist here.

View the complete Pediatric Celiac Disease Follow-Up Checklist here.

Aside from helping you navigate the gluten-free diet, here are my top 10 reasons to work with a dietitian:

  1. You feel confused or overwhelmed… Your dietitian can help you interpret the most recent research and regulations about the gluten-free diet. Research on celiac disease and non-celiac wheat sensitivity is still evolving and can be confusing for non-scientists to understand. Recommendations may have changed since you were diagnosed and you may be following out-of-date rules.
  2. imgresYou don’t know how to talk to your doctor… Your dietitian is a skilled liaison for communicating with your doctor and advocating for your needs. He/she can also help translate your medical results into plain English to help you understand the disease.
  3. You know this is going to be difficult… Your dietitian is with you for the long-haul because change doesn’t happen overnight. Step-by-step changes are essential for making long-term lifestyle transformations, such as adapting to the gluten-free diet. Your dietitian can coach you through each stage of re-learning how to eat for your body. Setting and evaluating goals with a dietitian can help you work toward a healthier you, while tackling challenges along the way.
  4. You need help with more than just your diet… Your dietitian can refer you to many resources to help improve your quality of life, including mental healthcare providers, support groups, advocacy and educational programs, and more.
  5. You value quality time… Your dietitian can generally meet with you for 30-60 minutes longer than your doctor can. He/she may recognize things that your doctor doesn’t, and can collaborate with him/her to make sure you get the best care possible.
  6. imgresYour family doesn’t understand… Dietitians are experienced at working with families when one member of a household is required to change his/her diet. Role-playing with your dietitian can be beneficial, and family sessions can help your family take your needs seriously.
  7. You may not be sticking to your diet… Up to 50% of Americans with celiac disease are not strictly compliant with the gluten-free diet. Evaluation by a dietitian may be the only way your doctor can understand why you continue to have elevated blood antibodies, an abnormal follow-up biopsy, or health problems that result from consuming gluten. A good dietitian will help you gradually work toward better compliance so that you can thrive on the gluten-free diet.
  8. You may not be feeling your best… A dietitian will be able to determine if hidden gluten is contributing to your symptoms, if nutritional deficiencies are causing you to feel sluggish, or if you need to be re-evaluated by your doctor for a number of conditions which might be contributing to your ongoing symptoms.
  9. You have multiple dietary restrictions… If you have a reason for limiting more than just gluten in your diet, meeting with a dietitian is important to make sure that what you are eating is nutritionally balanced. From diabetes to vegetarianism, food allergies, inflammatory bowel disease, iron-deficiency, and religious diets, it can be very complicated to get enough physically-nourishing food to maintain good health. Dietitians are specifically trained to manage multiple dietary restrictions.
  10. You’re ready for a life change… Perhaps this diagnosis is bringing your life into focus, and you realize that what you eat plays a vital role in your health and happiness. Your dietitian can help you maximize the value of the food you eat by suggesting changes beyond the gluten-free diet that can further improve your life.

Search the CDF Healthcare Practitioner Directory for an expert dietitian near you. If there are no dietitians within a reasonable distance, I encourage you to consider remote counseling with one of the many professionals in our directory who conduct telehealth sessions.

 

1Herman et al. (2012). Patients with celiac disease are not followed up adequately. Clinical Gastroenterology and Hepatology 10(8): 893-899. Celiac Disease Follow-Up Checklists

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