New patients

New patient appointment checklist

The following is a checklist of important areas to cover when seeing a patient who is newly diagnosed with coeliac disease. There are a lot of areas to cover, so you may need more than one appointment to go through all the information: 

• weight, height, BMI
• symptoms - before and after diagnosis. Some patients may not attribute any health problem specifically to their coeliac disease - you may need to help them retrospectively identify their symptoms
• assess the patient's understanding of coeliac disease - they may have accessed information from a variety of sources before attending the appointment
• explanation of coeliac disease - what it is and how it affects the body
• gluten free diet - explain what gluten is, where you find it and tools available to select safe foods such as gluten free labelling and allergen labelling, use Coeliac UK’s video guides to help
• highlight which foods are naturally gluten free, for example, rice, potatoes, plain meat, fish, eggs, cheese, milk, most yogurts, fruits, vegetables, pulses (peas, beans, lentils)
• assess the patient's understanding of the gluten free diet and consider involving other family members in dietary education
• explain how to introduce gluten free oats into a gluten free diet
• cross contamination with gluten and sensible steps on how to avoid it
• prescribable products – what is available and how patients can get gluten free food on prescription. Discuss prepayment certificates if the patient pays for prescriptions
• starter cards - should be given to the patient so they can order samples from a variety of gluten free manufacturers
• availability of gluten free food - discuss ranges available in supermarkets, health food shops, mail order and the internet
• eating out - discuss with the patient strategies to overcome challenges when eating out, for example, ring before going to a restaurant, inform staff about the gluten free diet and highlight the use of Coeliac UK Venue Guide
• explain how to use the Food and Drink Directory, including the importance of monthly updates
• calcium intake – highlight the importance of meeting the increased daily calcium requirements. Assess whether a supplement may be required. For children with coeliac disease, there is no recommendation for increased calcium requirements, so a calcium rich diet using Reference Nutrient Intakes (RNI) as a guide is appropriate
• consider other lifestyle issues which may impact on bone health, for example, regular weight bearing activity, avoid smoking and excess alcohol. Check if the patient has been referred for a DEXA scan
• as well as ensuring the diet is gluten free it is also important to ensure the diet is well balanced in line with general healthy eating recommendations
• consider any other dietary restrictions, for example if they are also following a vegetarian or vegan diet, are lactose intolerant, or if they have diabetes
• give the patient advice on vaccinations and medications
• arrange a follow up appointment
• give the patient a current Coeliac UK membership form and information on the services the charity provides. Both of these can be found on the right hand side of this page.