By Karen Kier, Pharmacist on behalf of the ONU HealthWise team
Two things come to mind when I think about bread. One is the wonderful smell of freshly baked bread and the other is the musicians of Bread. Recently, my daughter was trying to explain to her friends that there really was a group called Bread and it was one of her mother’s favorites! Her friends thought that was odd (no comment on some current band names). Interestingly, the group chose their name after getting stuck behind a Wonder bread truck. But today, I want to focus on celiac disease and the gluten proteins found in many delicious forms of bread.
The abbreviation BROW is used to help educate on the grains to avoid with celiac disease. BROW stands for barley, rye, oats, and wheat. Avoid barley, rye, and wheat grains and be cautious of oats. Some oat products can be gluten-free so labeling is important if oats have been included in the product.
May is Celiac Disease Awareness Month and it is an important time to discuss this autoimmune disease. If someone has celiac disease, the gluten proteins found in certain grains will trigger an immune response in the small intestine. This attack of the tissue over time results in damage to the lining of the gastrointestinal tract and prevents the body from absorbing key nutrients. The damage to the small intestine will cause individuals to have diarrhea, weight loss, bloating, tiredness, and anemia (blood cell changes). The diarrhea can cause essential electrolytes such as potassium and chloride to be low. The change in the lining can decrease absorption of essential minerals like calcium, which then causes bone loss.
Celiac disease sometimes can manifest as an itchy, blistering skin condition with a rash occurring on the elbows, knees, abdomen, and scalp. The individual may not show signs of a digestive problem. This skin condition is known as dermatitis herpetiformis and healthcare providers will often recommend a gluten-free diet to control the rash.
There is no cure for celiac disease and the best therapy is to strictly adhere to a gluten-free diet. Even small amounts of gluten can cause a person with celiac disease to be sick for days. A person with celiac disease was recently handed a cup of coffee in which the vendor put in a pasta straw rather than a plastic straw. The individual told the vendor that they had celiac disease and could not drink the coffee and asked to have it replaced. Without much consideration for the seriousness of this disease, the vendor told the person they gave them a new cup of coffee but indeed just put a plastic straw in the old cup. The person was sick for two days.
Some individuals chose to be gluten-free for other health benefits without having a diagnosis of celiac disease and there is nothing wrong with that choice. Some vendors have the attitude towards this as they do when others choose to be vegan or vegetarian option. A friend of mine is a vegetarian and has been intentionally served meat by some vendors when they have ordered a plant-based hamburger choice. Not a very nice thing to do.
Patients with celiac disease have to be gluten-free to control their disease and improve their health. So, when they request gluten-free it is important. As a pharmacist, it is important for me to help them choose gluten-free medication options. Many foods, as well as medications can contain hidden gluten. Food labels are required to include ingredients to help consumers make good choices. Over the counter medications are required to list inactive ingredients on the label in alphabetical order so that gluten can be identified.
Gluten can be used as a binding agent in medications so it is important to read labels for over the counter products and ask your pharmacist about gluten in your prescription products. When I teach celiac disease to student pharmacists, I give them examples of some generic medications with both gluten, as well as gluten-free versions. One example I like to use is the drug metformin. Some generic manufacturers use wheat starch in their product, while other companies make a gluten-free product. The purchasing agent for the pharmacy may change companies and not be aware of the change in gluten content. It is not unusual for a pharmacist to call the ONU HealthWise Drug and Health Information Center to ask for advice in finding a gluten-free option for a patient. The Center has resources to identify gluten in products. Various websites for consumers can be helpful including celiac.org and celiaccommunity.org.
If you need help finding gluten-free medications, ask your healthcare provider!
Feel free to call the ONU HealthWise Pharmacy for the advice on gluten-free medications. ONU HealthWise is offering COVID-19 including boosters Monday through Friday from 10 AM to 5 PM. Call the pharmacy for an appointment for other time slots. The ONU HealthWise pharmacy offers Moderna and Pfizer COVID-19 vaccines. Call the pharmacy to get more information.
ONU HealthWise Pharmacy
419-772-3784
www.onuhealthwisepharmacy.com
