Laboratory/ Diagnostic Testing
- Serology (Tissue transglutaminase, deamidated gliadin peptide can be used for monitoring CD)
- Vitamins & Minerals- A, D, E, B12, folic acid, copper, zinc, ferritin, iron, calcium (if previously abnormal)
- CBC- if previously abnormal
- LFTs- if previously abnormal
Medication Management (including vitamins & minerals)
- Vitamin B complex if appropriate
- Supplemental vitamin D based on vitamin D level
- Calcium intake at least 1000mg per day
- Fiber supplement if appropriate
Screening/ Heath Promotion Activities (including vaccination recommendations)
- According to CDC recommendations for adults
Anticipated Diet Education Needs
- Consider reintroduction of lactose containing dairy products
- Consider reintroduction of gluten-free oats
- Encourage high-iron and high-folate foods
Quick Text
Greater than 40 minutes of face-to-face time was spent with this patient today with over half this time involving: Gluten free diet education, rx medication management, counseling, and co-ordination of care. Many questions were answered to pt satisfaction.
PLAN: Labs- including cbc, cmp, celiac serology, and vitamin/minerals. Comprehensive Gluten free diet discussed and handouts given. Pt understands need for Gluten free diet is a life-long commitment to reduce risks of complications associated with malabsorption and chronic inflammation- including Lymphoma. 100% Gluten free diet is recommended. Continue super B complex (plus folic acid, vitamin d, and iron if indicated). Bone density scan (baseline within one year of diagnosis).