[Dietary treatment of coeliac disease and dermatitis herpetiformis]

Life-long gluten-free diet is the established therapy for coeliac disease and dermatitis herpetiformis. Diet therapy allows the intestinal mucosa to recover, improves nutrient malabsorption, osteoporosis and a weakened general condition. A gluten-free diet is without wheat, rye and barley and related products. Oats tested free of contamination by other cereals has recently been allowed for adult coeliac patients, but concern still remains regarding its general safety. Gluten-free flour mixes contain more starch and less proteins, vitamins, minerals and fibre compared to regular flour. Recently some questions have been raised as to the nutritional quality of the gluten-free diet. Successful therapy with gluten-free diet requires motivation and dietary counselling, including knowledge of the nutritional value of foods, labelling of prepackaged foods and practical training in cooking. The local chapters of the Norwegian Coeliac Society are active partners, as are the clinical nutritionists that work in most major hospitals. The physician making the diagnosis has a duty to see to it that all coeliac patients get adequate dietary counselling and management.