Have you recently been diagnosed with Coeliac Disease (CD) or have had a diagnosis for a while and are developing new symptoms or looking to change up your diet or your weekly meals?
When I ran classes for patients who were newly diagnosed with CD we would have fabulous discussions around where to seek help and support that was reliable and useful!
Here are the top 5 I would recommend:-

1. Number 1 has to be Coeliac UK website. They are a fantastic organisation that uses membership money to fund the website, research and resources for people with coeliac disease. www.coeliac.org.uk/home/
2. Support groups on Facebook for example. As I worked in the Wirral I would always recommend my local group to new patients. There are usually great conversations about restaurants and café recommendations, questions about their gluten free food prescriptions, sharing experiences of going abroad etc. Obviously, the contributors are patients, and not healthcare practitioners, so it's important to remember this if people share their pearls of wisdom!
3. A specialist dietitian - Dietitian's like myself who specialise in gastrointestinal disorders are invaluable if you want personalised and efficient support. Sadly, waits for NHS appointments can be considerable. Search for experts via websites such as the British Dietetic Association www.bda.uk.com/find-a-dietitian.html
4. Reliable sources on social media are also fantastic for resources such as recipes, or lists of the latest gluten free food products in supermarkets, or announcements from the FSA. Such examples are www.facebook.com/coeliacbydesign and 
glutenfreecuppatea.co.uk/
5. Other websites such as Guts UK, Patient Info, and NHS UK all provide a wealth of information for you to read and review.

If you have gastrointestinal symptoms which occur regularly (and sometimes simultaneously) such as bloating, change in bowel habits, fatigue, pain or vomiting - in particular when eating foods containing gluten, please book to see your GP. Continue to include gluten in your diet in order for any future tests to be accurate. Your GP can order a coeliac screen for you which involves a blood test to look for raised antibodies specific to coeliac disease. Coeliac UK website also has a self-assessment test you can conduct for further insight: - www.coeliac.org.uk/do-i-have-coeliac-disease/?&&type=rfst&set=true#cookie-widget

The British Dietetic Association has some fab information on what a dietitian is and what they do.. here's a little snippet for your reference:- 
The full article can be found here:- 
www.bda.uk.com/about-dietetics/what-is-dietitian.html
Dietitians are qualified and regulated health professionals that assess, diagnose and treat dietary and nutritional problems at an individual and wider public-health level.
They use the most up-to-date public health and scientific research on food, health and disease which they translate into practical guidance to enable people to make appropriate lifestyle and food choices.

Is the title of 'dietitian' protected by law?
Yes, the title ‘dietitian’ is the only food and nutrition title that is protected by law. Only those registered with the statutory regulator, the Health & Care Professions Council (HCPC) can use the title.
Who are they regulated and quality assured by?The role of the HCPC is to protect the public. It is an independent, UK-wide health regulator. The HCPC keeps a current register of health professionals who meet its standards and takes action if registered health professionals fall below those standards. Registered professionals must keep up-to-date through compulsory Continuing Professional Development (CPD).
If an individual is not happy with the treatment they are given, or if they are worried about the behaviour or health of a dietitian, they can approach the HCPC who will investigate and take action.
HCPC Registration
Dietitians are the only nutrition professionals to be regulated by law, and are governed by an ethical code to ensure that they always work to the highest standards.
All dietitians are regulated by the HCPC. The HCPC exists to protect the public. They publish a register of dietitians and other health professionals who meet their standards. Only those on the Register can call themselves dietitians.
You can find out details of all dietitians who currently practise in the UK by visiting the HCPC website and checking its register.
If you see an unregistered person claiming to be a dietitian, please get in touch with the HCPC.
What qualifications do dietitians have? The minimum requirement is a BSc Hons in Dietetics, or a related science degree with a postgraduate diploma or higher degree in Dietetics.
Dietetic courses are structured to include biochemistry, physiology, applied sciences and research methods that underpin nutrition and dietetics. These are complemented by social and behavioural sciences and the theories of communication to support the development of skills required for professional dietetic practice.
All courses require a period of supervised practice including NHS settings, where an individual must demonstrate clinical and professional competence before being eligible to apply for registration.
The British Dietetic Association (BDA) is the professional body and Trade Union and is also responsible for designing the curriculum for the profession. Courses must be approved by the HCPC and demonstrate that graduates meet the Standards of Proficiency for Dietetics.
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I had the pleasure of writing this article recently with the aim to review the IBD management clinical guidelines produced by three organisations, 1) The British Dietetic Association (BDA), 2) the British Society of Gastroenterology (BSG), and finally 3) the European Society for Parenteral and Enteral Nutrition (ESPEN) see Table 1. These guidelines were developed by clinical experts and patients. They involved the systematic review of thousands of published articles and recommendations were produced via the eDelphi online consensus agreement platform. The guidelines frequently rely on expert opinion-based recommendations or ‘Good practice points’ (GPP) due to limited empirical evidence available within a particular research area. Generally,  guidelines are developed to improve access to current research evidence for practitioners. The BDA states their ultimate aim with this guideline is to
“increase equality of care in nutritional assessment and dietary management of IBD.” (BDA, p.368)
It was great to have an in-depth look at the guidelines and being able to reach a wider audience to support their learning as well as mine!
The full article is available at 
​https://nutrition2me.com/

The Northwest Gastro Dietitians Group (NW GDG) established in October 2021, is an active voluntary group comprised of gastroenterology specialist dietitians working in NHS Trusts across NW England. The group was established following the publication of the Getting It Right First Time (GIRFT) gastroenterology report in September 2021. This report highlighted the need for regional networks to enhance collaboration, and share best practice within gastroenterology professions, with the aim to improve patient care. GIRFT is “a national programme designed to improve medical care within the NHS by reducing unwarranted variations”. 
The event hosted a range of esteemed speakers who delivered educational sessions relevant to dietetic practice and service management. This excellent study day was kindly sponsored by Stanningley Pharma and Abbott Nutrition Ltd.
​My write up of the day has been published in CN Magazine: 
https://nutrition2me.com/publications/complete-nutrition/

Topics included: 

1. Pre-habilitation in Liver Disease
   
2. Business Cases in Dietetics 
   
3. How to transition patients from paediatrics to adult Care 
   
4. Allergy in Adults
   

Key takeaways
1. Liver disease: Research suggests that 40-70% of patients with liver cirrhosis patient can present with sarcopenia, which is characterised by the loss of muscle mass, strength (Sinclair M et al 2016) and is associated with poor treatment outcomes (Son, 2021)​. This loss of muscle mass is associated with poor dietary intake and protein energy - malnutrition. Therefore, key nutritional strategies can be implemented to overcome this complication in chronic liver disease. Indeed, as practitioners we should encourage patients to have high calorie, higher protein-containing snacks to improve their protein intake and reduce the incidence of sarcopenia.
2. Business cases in Dietetics -key tips!
1. Build up your case​ by collecting data such number of dietetic referrals, utilisation rates, service evaluations, patient satisfaction surveys, etc.
2. Rationale: focus on patient benefit​ and therapy outcomes
3. Don’t give up (you will be rejected a lot), keep going​!
4. Wait for the right opportunity​
5. Sometimes this means do different roles, and make different connection​s
6. Be enthusiastic!​
7. Make friends- life is too short and the NHS is a surprisingly small place
3. From paediatric to adult care
Communicating well can be key to a smooth transition and this session provided some thoughtful tips to consider!  Top tips!

1. Try not to speak in ‘young person’s lingo.
2. Speak to them directly (with eye contact) rather than to a parent/carer who may be present.
3. Speak clearly and concisely in layman’s terms rather than using complicated terminology.
4. Give them chance to respond to your questions, and do not fill in the silences
5. Encourage them to take ownership of their condition and treatment plan.

4. Allergy in adults
As practitioners we should ensure that a dietetic assessment includes a review of the symptom history alongside detailed dietary history. This should include questions on typical dietary intake (foods and fluids); assessment of anthropometric measures including any previous weight loss and adequacy of their diet. In terms of clinical history, this allows for identification of any possible mechanism of food allergy (i.e. IgE or non-IgE-mediated) and ensures that the correct foods/allergens are tested using the correct testing method.