Coeliac disease is an auto-immune condition triggered by intolerance to gluten. In coeliac disease, gluten, which is found in wheat, barley and rye causes an immune reaction, damaging the lining of the small intestine. As the lining becomes damaged, the surface area of the lining reduces, which reduces the body’s ability to absorb nutrients and minerals.

Coeliac disease affects 1 in 100 people in the UK but only 10-15% of those are diagnosed, with around 500,000 people undiagnosed in the UK.

Symptoms can vary considerably and any area of the body can be affected. Symptoms can include abdominal pain, bloating, diarrhoea/constipation, nausea, tiredness, muscle pain, anaemia, headaches, depression, recurrent miscarriages, skin problems and sometimes weight loss.

Symptoms can range from mild to severe or even no symptoms at all and can often be misdiagnosed as other conditions, in particular IBS (irritable bowel syndrome). Recent research by Coeliac UK – the charity providing advice and support for those with the disease – suggests that 1 in 4 coeliacs were incorrectly diagnosed with IBS before being diagnosed with coeliac disease.

Coeliac disease is a lifelong condition and if untreated can lead to various complications including osteoporosis, infertility and gastrointestinal cancer. However, once diagnosed, following a strict gluten free diet is protective against associated complications.

Coeliac disease is usually diagnosed by a blood test at your GP surgery. This will test for antibodies that the body makes in response to eating gluten. If the result is positive, diagnosis is confirmed by a gut biopsy carried out by a gastroenterologist. It is important to keep eating gluten for at least 6 weeks before testing to avoid a false-negative result.

For children with coeliac disease, recent guidelines stipulate that if the blood test shows a sufficient level of antibodies, children can be diagnosed without undergoing a gut biopsy. In these cases a genetic test would be used to follow up and confirm diagnosis.

If a close family relative (such as mother, father, brother or sister) has been diagnosed with coeliac disease, your chance of also having coeliac disease increases to 1 in 10. Many families now look to have other family members screened or genetically tested to see if they are also genetically disposed to coeliac disease.

Currently the only treatment for coeliac disease is a strict gluten free diet for life. In order for the small intestine to recover it is vital that a strict gluten free diet is followed, whether or not you are having symptoms. It is also important to avoid cross-contamination both in and out of the home.

Gluten cross contamination often occurs when you live with others who are not on a gluten free diet, and there is a risk of their foods contaminating yours with gluten – resulting in you suffering symptoms. These tips can help you avoid it:

• In the home use separate utensils for gluten free and non-gluten free foods
• If possible, stay away from wooden utensils and chopping boards as they are porous
• Wipe and clean all surfaces after preparing foods containing gluten
• Use separate chopping boards for gluten free and non-gluten free products
• Wash hands thoroughly after touching foods containing gluten
• Don’t allow “double-dipping” – butter knives used for spreading on bread and scraping more butter can leave crumbs behind
• Have two toasters in the house, but if you can’t then buy toaster bags – you can also take toaster bags with you when visiting friends or family

Intolerance of lactose – the sugar found in dairy products – is often associated with coeliac disease. This is because the enzyme that helps you digest lactose, called lactase, is found in the lining of the gut. When you have coeliac disease, the lining of your gut can be damaged by gluten, reducing your ability to digest lactose and resulting in uncomfortable symptoms such as nausea, diarrhoea and bloating.

Fortunately after following a gluten free diet for some time your gut can repair itself and you can enjoy dairy foods again, but until then you may want to avoid lactose to reduce your symptoms by following a gluten and dairy free diet. If this is the case, make sure you are getting plenty of calcium from other sources such as soya, tofu, green vegetables or even a dietary supplement.

If you have been diagnosed with coeliac disease, a strict gluten free diet is the only effective treatment to prevent the painful and often debilitating symptoms. However, when staple foods like wheat, rye and barley are removed from your diet, it can affect your nutritional intake and therefore your wellbeing. What’s more, the way coeliac disease damages your gut lining can mean you suffer from nutrient malabsorption.

The products you can get on a gluten free prescription are therefore specially formulated to help people with coeliac disease get the nutrition they need; for example, our loaves are fortified with iron and calcium, and are also a source of fibre. This helps patients to enjoy a healthy, varied and balanced diet.

Any gluten free products must be approved by the Advisory Committee on Borderline Substances (ACBS) before they are available to those with coeliac disease on prescription. Various gluten free products and brands are available to order through your pharmacy, including Newburn Bakehouse – view our pharmacy products page for more information.

In England you need to pay for gluten free prescriptions. However, you can save money using an NHS Prescription Prepayment Certificate where you pay upfront for a 3 or 12 month period and receive unlimited prescriptions during that time. Some people (e.g. under 16s, over 60s) are exempt from prescription charges, and in Scotland, Northern Ireland and Wales prescriptions are free of charge.

The number of units your doctor prescribes will depend on your gender and age, to meet your calorific requirements. For example, an adult male will receive 18 units per month, and an adult female 14 units per month. It can also depend on where you live. View the Coeliac UK prescriptions guide for more information.

The units assigned to the prescribable gluten free food items are:

• 400g bread: 1 unit
• 100-250g rolls/baguettes: 1/2 unit
• 250-400g rolls/baguettes: 1 unit
• 100g savoury biscuits/crackers: 1/2 unit
• 200g savoury biscuits/crackers/crispbread: 3/4 unit
• 2 x 150g pizza bases: 1 unit
• 500g flour mix or bread mix: 2 units
• 250g pasta: 1 unit
• 500g pasta: 2 unit

Fresh bakery products such as bread and rolls come in set packs and therefore set units. The typical packs contain 8 bread, rolls or a mixture, however Newburn Bakehouse offers 4 in a pack, to help you get the most out of your unit allocation.

Ask your GP to provide a repeat prescription. However, if you want to change the products you receive you may need to change your prescription by visiting your GP or asking at your local pharmacy.

NHS Scotland have a Gluten Free Food Service with information specifically tailored to those living in Scotland. The Scottish Gluten-free Food Service is an NHS service available through your local pharmacy.

This service allows you to:

• Order and receive gluten-free food without the need to go through your GP.
• Have more control over the amount and type of foods you order each month (up to an agreed amount).

Find out more on the Scottish Gluten Free Food Service at NHS inform.

You can collect your order from the pharmacy as you would a medicine. However, online services are also available offering gluten free prescription delivery – our products are available to order through the online pharmacy company Dialachemist, who deliver to your chosen delivery address.

We have supported and partnered with leading healthcare professionals and professional bodies, to develop guidelines on managing coeliac disease. Until recently there was very little information or training on coeliac disease available to GPs, which may explain why only an estimated 24% of sufferers have been diagnosed. We have also supported the work of the British Dietetic Association, including its Gastroenterology Specialist Group.