Happy Kids With Healthy Bodies

Teenagers With Coeliac Disease

How do I know if my teenager has coeliac disease?

Teenagers with CoeliacTeenagers can develop Coeliac disease just like anyone else.

You may notice these symptoms:

  • weight loss
  • swollen tummy
  • stomach ache
  • very smelly diarrhea
  • stools appear fatty and airated
  • joint pain
  • skin rash

The skin rash is called dermatitis herpetiformis which is painful and contains blisters which can burst.

Getting an initial diagnosis is fairly simple in the form of a blood test. Coeliac disease can be misdiagnosed as the symptoms vary from one person to another and are very similar to a number of other conditions.

It is important to see a doctor before embarking on a gluten free diet. This is a life changing disease and needs to be handled with care and sensitivity. Teenagers are very much in control of what they eat when they are out and about, so getting them onboard and with the right information is essential!

 

 

 

What is gluten?

Wheat Seeds - Gluten containing cerealGluten... a protein

Gluten means glue in Latin. It is a protein that appears in wheat, rye, barley and oats. The gluten makes food stretchy and elastic, so is ideal for making breads and cakes. The gluten allows the breads to rise and hold it's shape. Wheat gluten is more stretchy than other rye, barley and oats which is why it is the most commonly used and why rye bread for example is much more dense.

Gluten in breads

When a dough is allowed to rise due to the fermentation process involving yeast and sugar, bubbles occur... these are held within the dough due to the elasticity of the gluten, therefore the dough rises and holds its shape during baking.

Gluten Free Baking

This can be challenging because gluten does its job so well. A blend of flours is usually the key and there are many ready mixed bread flours, if you are tempted to start gluten free baking. Read our - Useful tips for making better bread! to help you find the a great gluten free bread.

Diabetes and Coeliac Disease

A person is diagnosed with diabetes when their body cannot use glucose properly. The unused glucose, at high levels in the blood stream, can cause damage to other parts of the body such as heart disease, kidney disease, circulation problems and nerve problems.

Coeliac Disease and Diabetes 1 are both autoimmune diseases. Children and adults with diabetes are more likely to develop coeliac disease as it is believed they are genetically linked.

Type 1 diabetes

Type 1 Diabetes is an autoimmune disease where the body reacts and destroys the insulin producing beta cells in the pancreas. In order for the body to use glucose (simple sugars which are broken down from the food we eat by our digestive system), insulin has to be produced otherwise the body will starve.

Everyone needs insulin to survice, whether they produce themselves or inject it. 

Type 2 diabetes

Type 2 diabetes is usually hereditary and has a genetic link, so some people are more of a risk at developing type 2 diabetes. You maybe at an increase risk if you have a close family member with Type 2 diabetes such as you sister or father etc, if you are overweight or gesational diabetes (diabetes during pregnancy).

Type 1 or 2 and coeliac disease

Living with Type 2 and coeliac disease will affect your diet and foods need to be carefully chosen. A gluten free diet is essential combined with low fat, high fibre, starchy foods, fruits, vegetables, beans, legumes and pulses.

Eat well

It will be important to eat foods to control the blood sugar levels in your diet and choose gluten free options.

5 Tips for a coeliac and diabetic diet

1. Eat meals gluten free meals regulary, do not skip meals. You wil reduce the erge to snack and help control blood glucose levels. Seeded breads and pasta. Chickpeas and quinoa have a low glyceamic index. Buckwheat flakes can be bought for breakfast or quiioa porridge is naturally gluten free. Eat starchy vegetables such as potatoes, sweet potatoes and yams.

2. Eat more fruit, veg legumes and beans. The government's initiative aims to get everyone eating 5 portions a day. Fresh, canned (in fruit juice) or frozen varieties make this easy to achieve. One portion is equal to 2 satsumas, 1 banana, a tablespoon of mixed dried fruit and nuts, a glass of fruit juice etc. Peas, beans and pulses are naturally gluten free and real tummy fillers. Try a buckwheat salad or chickpea curry or burgers. Chickpeas help to control blood sugar levels.

3. Eat low fat, low salt and low sugar. Reduce your fat intake to lose or control your weight. Use semi or skimmed milk, low fat spreads, cheeses and yoghurts. Try grilling, baking and steaming rather than frying. Choose tomato based sauces rather than cheese sauces. Salt can rase blood pressure so reduce the amount you add in cooking and sprinkled on your dinner. Ready meals and processed foods contain high quantities of salt and stock cubes are primarily salt... try to keep to less than 6g a day for an adult and less for children. Sugar can be eaten in moderation and will effect your blood pressure. Choose low sugar options, preferably natural choices with stevia , a sugar free alternative, for example or no added sugar varieties.

4. Limit alchohol. Remember to choose gluten free varieties and preferably drink with a meal to avoid a hypoglycemic episode. Wine and spirits, sherry and port etc are possible acceptable.

5. Eat lean meats and fish. These are naturally gluten free and can be cooked in a variey of delicious ways. experimient with new flavoursome recipes. Oily fish can reduce heart disease, stemed fish can be a light option and chicken casseroles are easy meals that can be eated for a day or two.

A gluten free diabetic diet can be just as delicious as any other diet and trying new foods with your coeliac and diabetic child can be a new adventure. Take care with diabetic foods as low sugar, may not mean low fat and calorific plus they are expensive too!

 

Try some fab gluten free recipes in our cookbook

Gluten Free Foods on Prescription

If you are diagnosed with Coeliac Disease you can receive a quantity of gluten free foods on prescription to help with your diet. Foods include bread, flour, pasta and pizza bases for example. The NHS will allow a number of units to be prescribed dependending on your age and sex (see table below).

What gluten free foods can I get on prescription?

How many units can I get on prescription?

Age and sex

Units per month

child 1-3 years

10

child 4-6 years

11

child 7-10 years

13

child 11-14 years

15

child 15-18 years

18

male 19-59 years

18

male 60-74 years

16

male 75+ years

14

female 19-74 years

14

female 75+ years

12

breastfeeding

add 4

3rd trimester pregnancy

add 1

high physical activity level

add 4

The Advisory Committee on Borderline Substances (ACBS) dictates what can be available on prescription and most doctors follow these guidelines. Doctors are allowed to prescribe other gluten free foods if they feel it is necessary for your welfare.

How often can I get food?

The units are based on a monthly order and some foods may be worth more than one unit.

Prescription Charges

Prescription charges apply in the normal way.If you are entitled to free prescriptions, you will receive your gluten free prescription charge free too!

A balanced diet

It is important to chose your gluten free prescription units carefully and think about ordering a balanced diet.

The choice of foods may change over time and a new prescription will need to be generated everytime you want to make a different choice, which may be fairly regularly until you know what foods you like and dislike.

Primary Care Trusts across the country may offer different foods and products, so it is worth getting a list from your local PCT before ordering.

 

A sample order for a 5 year old child of 11 units

3x 400g Sliced Bread (3 units) 
2x 180g Pizza Bases  (1 unit)
1x 500g Pasta Spirals (2 units)
1x 150g Savoury Crackers (1 unit)
1x 500g Flour Mix (2 units)
1x 250g Lasagne Sheets (1 unit)
1x 150g Digestive Biscuits (1 unit) 

NB - some products may contain codex wheat starch

A sample order for a 13 year old child of 15 units

3x 400g Slice Bread (3 units)
1x 425g Bread Rolls (1 unit)
2x 180g Pizza Bases (1 unit) 
1x  500g Macaroni (2 units)
1x 500g Penne Pasta (2 units)
1x 500g Flour Mix (2 units)
2x 150g Digestive Biscuits (2 units)
2x 150g Savoury Crackers (2 units) 

NB - some products may contain codex wheat starch

Download your prescription lists

This list is not all the manufacturers of foods on prescription so please ask your doctor for a complete list. These manufactures have lists readily available for download.

Juvela Prescription pdf

Glutafin Prescription List

Barkat Prescription pdf

Orgran Prescription pdf

Genius Prescription Info

Livwell Prescription Info

Proceli Prescription pdf

A list of gluten free products on prescription

Gluten Free Bread

 

 

Barkat

Brown Rice Sliced Bread 500g (PIP Code: 244-0691)

Home Fresh Par-baked Baguettes 200g (PIP Code: 327-9023)

Home Fresh Par-baked Country Loaf 250g (PIP Code: 327-1186)

Home Fresh Par-baked White Bread 550g (PIP Code: 327-1178)

Multigrain Sliced Bread 500g (PIP Code: 291-2871)

Par-baked Baguettes 200g (PIP Code: 339-4970)

Par-baked White Sliced Bread 300g (PIP Code: 339-4996)

White Rice Sliced Bread 500g (PIP Code: 244-0709)

Wholemeal Sliced Bread 500g (PIP Code: 339-4889)

 

 

Dietry Specials

GLUTEN & WHEAT FREE

Brown Multigrain Loaf – Sliced (PIP Code: 289-8690)

White Loaf – Sliced (PIP Code: 282-3771)

White Multigrain Loaf – Sliced (PIP Code: 306-8541)

 

 

Ener-G

Brown Rice Bread (PIP Code: 212-2470) 474g

Rice Loaf – Yeast Free Sliced (PIP Code: 233-5362) 612g

Seattle Brown Loaf Sliced (PIP Code: 288-1324) 454g

Six Flour Loaf Sliced (PIP Code: 293-6474) 454g

Tapioca Bread Sliced (PIP Code: 233-5370) 480g

White Rice Bread Sliced (PIP Code: 225-9455) 456g

 

 

Genius

Fresh Gluten-Free White Bread Unsliced 6 x 400g (PIP Code: 357-8333)

Fresh Gluten-Free Brown Bread Unsliced 6 x 400g (PIP Code: 357-8325)

 

 

Glutafin

GLUTEN & WHEAT FREE

Baguettes x 2 (PIP Code: 224-0117)

Fibre Loaf – Sliced (PIP Code: 237-7356)

White Loaf – Sliced (PIP Code: 090-4268)

 

SELECT GLUTEN FREE

Fibre Loaf – Sliced (PIP Code: 054-6101)

Fresh Brown Loaf (PIP Code: 330-6800)

Fresh White Loaf (PIP Code: 290-6840)

Part-Baked White Loaf (PIP Code: 241-8697)

Seeded Loaf – Sliced (PIP Code: 308-9364)

White Loaf – Sliced (PIP Code: 054-6093) 

 

Juvela

Fibre Loaf – Sliced (PIP Code: 074-8632) 400g

Fibre Loaf – Unsliced (PIP Code: 010-1675) 400g

Fresh Fibre Sliced Loaf (PIP Code: 339-9789) 400g

Fresh White Loaf – Sliced (PIP Code: 322-0217) 400g

Loaf – Sliced (PIP Code: 074-8590) 400g

Loaf – Unsliced (PIP Code: 031-4781) 400g

Part-baked Fibre Loaf (PIP Code: 273-6890) 400g 

Part-baked Loaf (PIP Code: 273-6882) 400g

 

 

Lifestyle

Brown Bread Slices 400g (PIP Code: 087-6557)

Brown Bread Unsliced 400g (PIP Code: 087-6698)

High Fibre Bread 400g (PIP Code: 213-2959)

White Bread Sliced 400g (PIP Code: 087-6490)

White Bread Unsliced 400g (PIP Code: 087-6516)

 

 

Livwell

2 Garlic & Coriander Naan Breads – Tear Drop Flat Breads (PIP Code 339-8591)

Flat Breads (PIP Code: 339-8583)

 

WHEAT, GLUTEN & MILK-FREE

Baguette (PIP Code: 322-1199)

Garlic & Coriander Naan Bread

Seeded Bread (PIP Code: 322-1181)

White Bread – Sliced (PIP Code: 322-1173)

 

 

Pasticely

Sandwich Bread (PIP Code 353-8709)

White Baguette (PIP Code 353-8733)

White Rustic Sliced Bread (PIP Code 353-8725)

 

 

Proceli

2 Part Baked Baguettes (Crusty) (PIP Code: 328-2803) 250g

3 Part Baked Flat Bread (Pitta) (PIP Code: 328-4478) 120g

Brown Rice Bread (PIP Code: 328-4452) 220g

Sandwich Bread (PIP Code: 328-4528) 155g

Sandwich Rice Bread (PIP Code: 328-4510) 220g

Sliced White Bread (PIP Code: 328-4593) 165g

Updated September 2010 Updated September 2010

 

 

Wellfoods

GLUTEN, WHEAT, DAIRY & LACTOSE FREE

Loaf (PIP Code: 316-6113) 600g

Loaf – Sliced (PIP Code: 316-6121) 600g

 

Gluten free bread rolls

 

Barkat

Home Fresh par-baked Bread Rolls 300g (PIP Code: 325-4679)

Par-baked Rolls 200g (PIP Code: 339-4988)

 

 

Ener-G

Dinner Rolls (PIP Code: 317-5502) 280g

Seattle Brown Rolls Hamburger (PIP Code: 295-5870) 320g

Seattle Brown Rolls Hot Dog (PIP Code: 295-5888) 320g

White Long Rolls Hot Dog (PIP Code: 327-1947) 220g

White Round Rolls Hamburger (PIP Code: 327-1954) 220g

 

 

Glutafin

GLUTEN & WHEAT FREE

Fibre Rolls x 4 (PIP Code: 344-3652)

White Rolls x 4 (PIP Code: 344-3645)

 

SELECT GLUTEN FREE

Fibre Rolls (PIP Code: 302-3405)

Part-Baked 2 Long White Rolls (PIP Code: 344-3637)

Part-Baked 4 White Rolls (PIP Code: 344-2753)

White Rolls x 4 (PIP Code: 302-3413)

 

 

Juvela

Fibre Rolls (PIP Code: 080-3668) 5x85g

Fresh White Rolls (PIP Code: 355-8871) 5x85g

Fresh Fibre Rolls (PIP Code: 355-6800) 5x85g

Part-baked Fibre Rolls (PIP Code: 262-9020) 5x75g

Part-baked Rolls (PIP Code: 243-7267) 5x75g

Rolls (PIP Code: 010-5916) 5x85g

 

 

Lifestyle

High Fibre Rolls x5 (PIP Code: 224-0125)

Rolls - Brown 5x80g (PIP Code: 264-1322)

Rolls - White 5x80g (PIP Code: 087-6706)

 

 

Livwell

2 Ciabatta Rolls – Part Baked Square Dinner Rolls (PIP Code: 351-8552)

WHEAT, GLUTEN & MILK-FREE

2 Bagels - Part Baked Circle Bread Rolls (PIP Code: 335-4750)

White Rolls (PIP Code: 322-1207)

 

 

Pasticely

White Rolls (PIP Code: 353-8717)

White Rustic Rolls (PIP Code: 353-8691)

 

 

Proceli

3 Part Baked Long White Rolls (PIP Code: 328-2845) 250g

3 Part Baked White Rolls (Hotdog) (PIP Code: 328-2894) 105g

4 Part Baked White Dinner Rolls (PIP Code: 328-2928) 140g

8 White Lunch Rolls (PIP Code: 328-4395) 270g

 

 

Wellfoods

GLUTEN, WHEAT, DAIRY & LACTOSE FREE

Burger Buns (PIP Code: 316-6147) 4 Pack

Rolls (PIP Code: 316-6139) 4 Pack

 

 

Gluten Free Home Baking

 

Barkat

Bread Mix 500g (PIP Code: 051-5338)

Flour Mix 750g (PIP Code: 335-6672)

 

 

Dietry Specials

GLUTEN & WHEAT FREE

White Bread Mix (PIP Code: 253-4279)

White Cake Mix (PIP Code: 253-4303)

White Mix (PIP Code: 264-6792)

 

 

Glebe Farm

Gluten Free White Bread & Pizza Mix (PIP Code: 357-7863)

Gluten Free Brown Bread Mix 375g (PIP Code: 357-7871)

 

 

Glutafin

GLUTEN & WHEAT FREE

Bread Mix (PIP Code: 298-8418)

Cake Mix (PIP Code: 302-3397)

Fibre Bread Mix (PIP Code: 298-8426)

Multipurpose Fibre Mix (PIP Code: 231-2973)

Multipurpose White Mix (PIP Code: 231-2981)

Pastry Mix (PIP Code: 302-3389)

 

 

SELECT GLUTEN FREE

Bread Mix (PIP Code: 274-4951)

Cake Mix (PIP Code: 264-9994)

Fibre Bread Mix (PIP Code: 297-9912)

Multipurpose Fibre Mix (PIP Code: 004-5591)

Multipurpose White Mix (PIP Code: 004-5187) 

Pastry Mix (PIP Code: 270-1662)

 

 

Heron Foods

ORGANIC – GLUTEN, WHEAT & DAIRY-FREE

Bread & Cake Mix (PIP Code: 299-6437)

Hi-fibre Bread Mix (PIP Code: 299-6445)

 

ORGANIC – GLUTEN-FREE

Bread Mix (PIP Code: 229-6452) 

 

 

Il Pane Di Anna

Pizza Base Mix (PIP Code: 333-7466)

White Bread Mix (PIP Code: 333-7474)

White Cake Mix (PIP Code: 333-7458)

 

 

Innovative Solutions

Pure Brown Rice Flour (PIP Code: 325-7912) 500g

Pure Gluten-free Flour (PIP Code: 282-8580) 1kg

Pure Potato Starch (Flour) (PIP Code: 325-7920) 500g

Pure Tapioca Starch (Flour) (PIP Code: 325-7946) 500g

Pure Teff Brown Flour (PIP Code: 343-1467) 1kg

Pure Teff White Flour (PIP Code: 343-1483) 1kg

Pure White Rice Flour (PIP Code: 325-7904) 500g

 

 

Juvela

Fibre Mix (PIP Code: 023-6042) 500g

Harvest Fibre Mix (PIP Code: 349-3251) 500g

Harvest White Mix (PIP Code: 247-7875) 500g

White Mix (PIP Code: 035-2161) 500g 

 

 

Orgran

Bread Mix

Pizza & Pastry Mix

Plain Flour Gluten Free

Self Raising Flour Gluten-free

 

 

Proceli

Plain White Flour (PIP Code: 328-4577) 1kg

 

 

Tobia Teff

Brown Teff Flour (PIP Code: 346-6729) 1kg

White Teff Flour (PIP Code: 346-6711) 1kg

 

 

Wellfoods

GLUTEN, WHEAT, DAIRY & LACTOSE FREE

Flour Alternative (PIP Code: 314-2577) 1kg

 

 

Gluten Free Crackers and Crispbreads

 

 

Barkat

Matzo Crackers 200g (PIP Code: 337-8296)

Crackers 200g (PIP Code: 342-7457)

 

Dietry Specials

GLUTEN & WHEAT FREE

Cracker Bread (PIP Code: 305-5076)

 

 

Glutafin

GLUTEN & WHEAT FREE

Crackers (PIP Code: 009-3302)

Crispbread (PIP Code: 338-4443)

High Fibre Crackers (PIP Code: 018-7641)

Mini Crackers 175g (PIP Code: 353-5515)

Savoury Biscuits (PIP Code: 045-6749)

Savoury Shorts (PIP Code: 276-7515)

 

 

Juvela

Crispbread (PIP Code: 236-6136) 200g

Savoury Biscuits (PIP Code: 310-7893) 150g

 

 

Gluten free crossants, Buns and Pastries

 

Livwell

WHEAT, GLUTEN & MILK-FREE

4 English Muffins – Toasting Bread Buns (PIP Code 351-8552)

 

 

Proceli

Bread Buns (Ice Sugared) (PIP Code: 328-4445) 200g

 

 

Gluten Free Biscuits

 

Barkat

Coffee Biscuits 200g (PIP Code: 337-8288)

 

Dietry Specials

GLUTEN & WHEAT FREE

Hoops Tea Biscuits

 

 

Ener-G

Vanilla Cookies (PIP Code: 277-4610) 435g

 

 

Glutafin

GLUTEN & WHEAT FREE

Biscuits (PIP Code: 022-8387)

Digestive Biscuits (PIP Code: 017-0225)

Shortbread Biscuits (PIP Code: 316-7848)

Sweet Biscuits (PIP Code: 024-2966)

Tea Biscuits (PIP Code: 018-5868)

 

 

Juvela

Digestive Biscuits (PIP Code: 210-0923) 150g

Sweet Biscuits (PIP Code: 276-4959) 150g

Tea Biscuits (PIP Code: 210-0915) 150g

 

 

Gluten Free Pizza Bases

 

Barkat

Brown Rice Pizza Crust 150g (PIP Code: 259-2566)

White Rice Pizza Crust 150g (PIP Code: 259-3051)

 

 

Dietry Specials

GLUTEN & WHEAT FREE

Pizza Bases (PIP Code: 317-6088)

 

Ener-G

Pizza Bases x 3 (PIP Code: 295-5896) 372g

 

 

Glutafin

GLUTEN & WHEAT FREE

Pizza Bases x 2 (PIP Code: 334-1112)

 

 

Juvela

Pizza Bases (PIP Code: 265-4390) 2 x 180g 

 

 

Proceli

3 Pizza Bases (PIP Code: 309-8357) 375g

 

 

Wellfoods

GLUTEN, WHEAT, DAIRY & LACTOSE FREE

Pizza Bases (Twin Pack) (PIP Code: 316-6154) 300g

 

 

Gluten Free Baking Aids

 

Ener-G

Xanthan Gum (PIP Code: 272-4318) 170g

 

Innovative Solutions

Pure Xanthan Gum (PIP Code: 282-8572) 100g

 

Life ‘Free from’

Xanthan Gum (PIP Code: 324-2989) 115g

 

 

Gluten Free Pasta

 

Barkat

Animal Shapes Pasta 500g (PIP Code: 339-4913)

Buckwheat Pasta Penne 250g (PIP Code: 232-3319)

Buckwheat Pasta Spirals 250g (PIP Code: 232-2873)

Macaroni 500g (PIP Code: 339-4921)

Spaghetti 500g (PIP Code: 339-4947)

Spirals 500g (PIP Code: 339-4939)

Tagliatelli 500g (PIP Code: 339-4954)

 

 

Bialimenta

Pasta Tubetti (PIP Code: 351-1979) 500g

Potato Pasta Gnocchi (PIP Code: 351-1961) 500g

Potato Pasta Perle di Gnocchi (PIP Code: 351-1987) 500g

 

 

Dietry Specials

GLUTEN & WHEAT FREE

Fusilli Pasta (PIP Code: 305-5019)

Penne Pasta (PIP Code: 305-5027)

Spaghetti Pasta (PIP Code: 305-5043)

 

 

Ener-G

Lasagne (PIP Code: 023-8519) 454g

Macaroni (PIP Code: 209-7988) 454g

Small Shells (PIP Code: 081-0648) 454g

Spaghetti (PIP Code: 023-8493) 447g

Vermicelli (PIP Code: 023-9061) 300g

 

 

Glutafin

GLUTEN & WHEAT FREE

Lasagne (PIP Code: 215-5091)

Pasta Shells (Conchiglie) (PIP Code: 250-0676)

Pasta Spirals (Fusilli) (PIP Code: 211-5178)

Penne (PIP Code: 211-5152)

Spaghetti (PIP Code: 211-5160)

Tagliatelle (PIP Code: 215-5109)

 

 

Juvela

Fibre Linguine (PIP Code: 332-8002) 500g

Fibre Penne (PIP Code: 332-8010) 500g

Fusilli (PIP Code: 280-7980) 500g

Lasagne Sheets (PIP Code: 280-7972) 250g

Macaroni (PIP Code: 280-8004) 500g

Spaghetti (PIP Code: 280-7998) 500g

Tagliatelle (PIP Code: 319-3497) 250g

 

 

Orgran

Buckwheat Spiral Pasta

Corn Spirals

Rice Spirals

Lasagne Mini Sheets

Macaroni

Spaghetti Noodles

 

 

Proceli

Macaroni Pasta (Penne Rigate) (PIP Code: 328-4486) 250g

Pasta Spirals (Fusilli) (PIP Code: 328-4494) 250g

Puntini Pasta (Rice Substitute) (PIP Code: 328-4502) 250g

Short Spaghetti (Capellini) (PIP Code: 328-4551) 250g

 

 

Rizopia

ORGANIC BROWN RICE PASTA

Fusilli (PIP Code: 340-0074) 500g

Lasagne (PIP Code: 340-0108) 500g

Penne (PIP Code: 340-0082) 500g

Spaghetti (PIP Code: 340-0090500g

 

 

 

Fructose Malabsorption

Fuctose Malabsorption (FM) is a digestive disorder where defficient fructose carriers in the small intestine's enterocytes impairs absorption of fructose from foods OR very simply the inablity to absorb fructose.

Symptoms of Fructose Malabsorption

lemons can be eaten by people on a low fructose diet

Fructose Malabsorption can cause cramps, gas, and diarrhea and therefore can easily get confused with Coeliac Disease symptoms. In addition to these symptoms FM can also cause bad breath.

What is Fructose?

Fructose is the sugar found in most of the things we eat including in fruits and sugars. Fructose and glucose

are very simple sugars and require very little digesting and are usually easily absorbed by the body.

Why is Fructose Malabsorption a problem?

Usually, fructose is absorbed by the body within the intestines, but when it passes further down the digestive system and into the bowels, the number of bacteria in the bowels thrives and rapidly increases. The bacteria consume the fructose and produce waste profucts such as methane and hydrogen gas. These gases cause bloating, cramps, gas, diarrhea and bad breath.

Testing for Fructose Malabsorption

Fructose Malabsorption can be tested by measuring for the hydrogen in the breath. The hydrogen is released from the bacteria after digesting the fructose which is absorbed into the blood, then removed by the lungs and then exhaled in the breath,

Why do I have Fructose Malabsorption?

There are a number of reasons which would render the body unable to absorb fructose.

1. There maybe a genetic link, a hereditary factor which prevents the body aborsbing frucose, but this is very rare.

2. The bowels could be moving too slowly and therefore the fructose is not being absorbed and the bactria have time to feed and cause symotoms.

3. The GLUT2 and GLUT5 transporters are deficient and inefficient when moving the fructose across the intestinal wall and into the blood.

4. The overgrowth of bacteria in the small intestine devours the fructose in the small intestines before it can be transported acoss the intestinal wall into the blood stream.

5. Celiac disease patients can find they suffer from Fructose Malabsorption.

Coeliac Disease and Fructose Malabsoprtion

A number of studies have shown that Fructose Malabsorption may be a primary cause of Coeliac Disease and other studies show that overexposure to fruit once on a gluten free diet can cause Fructose Malabsorption.

How can I avoid high fructose containing food?

Avoiding fructose containing foods will alleviate symptoms. Abstaining from eating certain foods should imporve all symptoms. It is worth stopping eating these sugars completey for a short while to starve the bacteria. Avoid eating fructose, sucrose and sorbitol.

Fruit:

Apple, grapes, cherries, pear, guava, mango, watermelon, quince, paw paw, lychee, guava, pomegranate, dried fruit, fruit juice, star fruit, tomatoes, tomato paste.

Dried Fruit

Apple, raisins, fig, date, pear, sultana

Vegetables:

Onion, garlic, spring onion, shallot, leek, asparagus, artichoke, Jerusalem artichoke, witlof, chickory, radicchio, endive and dandelion greens.

Others:

Honey, coconut milk and cream, wheat, brown rice, fructose,  artificial sweeteners (ie sorbitol and xylitol), agave nectar,  and high fructose corn syrups (which are used a lot in soda drinks.

Drinks

Sports drinks, sweetened milk, fortified wines, fruit juice sweeteners (apple or pear juice concentrate),

Which foods are safer to eat?

It is worth noting that these foods are generally safer to eat and can cause less symptoms than the above foods, but there still can be accumulation effect. These are lower fructose foods.

Stone fruit

Apricot, nectarine, peach, plum (nb— these fruits contain sorbitol);

Berry fruit

Strawberry, raspberry,  blueberry, blackberry,  cranberry, boysenberry, loganberry


Citrus fruit:

Lemon, lime, kumquat, grapefruit,  mandarin, orange, tangelo


Other fruits

Ripe banana, kiwi fruit, pineapple, jackfruit, passion fruit, rhubarb, tamarillo.

Living with Coeliac Disease and Fructose Malabsorption

Many gluten free products including milks and breads can be sweetened with fructose. Avoid inulin which is high in fructose and is widely used in gluten free and fairy free products.

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