National prescribing guidelines written by Coeliac UK, the Primary Care Society of Gastroenterology and the British Dietetic Association provide recommendations on the quantities of gluten-free foods for prescribing purposes. Further information on gluten-free prescribing and a copy of these guidelines can be found on our website.

In babies, symptoms may develop after weaning onto cereals that contain gluten.

Symptoms in babies include:

• bloated tummy
• irritability
• diarrhoea and other gut symptoms
• faltering growth or a change in growth pattern

Find out more about coeliac disease in children here or you can call our helpline and speak to one of our dietitians.

Babies who have an increased risk of coeliac disease should be weaned in the same way as any other child. 

Find out more about feeding your baby here.

The symptoms of coeliac disease vary from person to person and can range from very mild to severe. Common symptoms include:

• frequent bouts of diarrhoea or loose stools
• nausea, feeling sick and vomiting
• stomach pain and cramping
• lots of gas and bloating
• feeling tired all the time, ongoing fatigue
• anaemia (you would be told if you’re anaemic following a blood test)
• weight loss (although not in all cases)
• regular mouth ulcers
• constipation or hard stools
• skin rash (dermatitis herpetiformis, the skin manifestation of coeliac disease).

If you have any of these symptoms, you can take our online assessment which is a short questionnaire on symptoms and other risk factors for coeliac disease.

Although we cannot recommend a specific consultant / Gastroenterologist, we suggest visiting www.specialistinfo.com or NHS choices for more information on consultants by speciality and geographic area.

Wheat is the basis of the staples in the diet and is therefore the most widely consumed grain in the UK. Removing gluten from the diet can therefore have significant impact on the diet.

Rates for adherence to the gluten-free diet can vary between 42-91% ^[1] and gluten free staples on prescription have been related to inadvertent adherence ^[2].  Non-adherence to the gluten free diet, the medical treatment for coeliac disease is associated with increased risk of complications including osteoporosis, infertility problems and in rare cases intestinal malignancy.

Research has shown that gluten free staple foods are 3-4 times more expensive than equivalents containing gluten ^[3,4]. Availability of gluten free food, particularly in budget supermarkets and corner shops is also limited or non-existent. These access problems underpin the need for provision of gluten-free staple food on prescription, particularly for those on a limited income or with limited mobility.

_{[1] Hall, N.J. Rubin, G. & Charnock, A. (2009). Systematic review: adherence to a gluten-free diet in adult patients with coeliac disease. Alimentary Pharmacology & Therapeutics, 30, 315-330.}

_{[2] Hall, N. et al. (2013). Intentional and inadvertent non-adherence in adult coeliac disease. A cross-sectional survey. Appetite 68 56-62}

_{[3] Singh, J. & Whelan, K. (2011). Limited availability and higher cost of gluten-free foods. Journal of Human Nutrition and Dietetics, 24, 479-486.}

_{[4] Burden, M., et al., Cost and availability of gluten-free food in the UK: in store and online. Postgraduate Medical Journal, 2015: p. postgradmedj-2015-133395}

Pregnancy holds no greater risks for women diagnosed with coeliac disease than those without, but it is important you follow a strict gluten free diet and make sure you get a good intake of calcium and iron.

It is also important that people with coeliac disease are followed up regularly, particularly at times of stress, such as pregnancy.

The administration cost of setting up a pharmacy led supply scheme for gluten-free food on prescription should be minimal.

A PCT in Cumbria piloted the pharmacy-led supply scheme in 2009. Existing members of their staff took on the administration tasks required to implement the initiative. This took a part time employee approximately three months – but it should be noted that this was to organise the scheme from scratch. Once the programme was in place, administration requirements comprised of data collection for finance and required approximately one working day per month.

We have designed a toolkit so that there is a template approach which can be simply rolled out in any new area and Coeliac UK is happy to help with communication to promote a smooth implementation.

In Northamptonshire, administration related mainly to devising contracts and paper claims. Initially this took a 0.4FTE around two weeks each month to process the claims. Since 2009 Northamptonshire has processed claims using an online claim service. This has proved very efficient and reliable, heavily reducing workload. The cost of this service would depend on the number of pharmacies and number of services commissioned. Northamptonshire use the online service for six enhanced services.

Pharmacy supply schemes are currently running in a number of parts of the UK. These schemes have resulted in significant cost savings while continuing to support people with coeliac disease on the gluten-free diet. Read more information on these schemes.