Celiac disease and milk - quiz question

[jjjoy, LPN]

I'm not going to copy the exact quiz question but a student recently asked about the diet recommendations for celiac patients. The quiz question asked if you'd include milk among other options including pasta. Well, clearly pasta (unless some special gluten-free variety) is out of the question. Apparently, the correct answer was to not include milk as well.

I did a quick search on celiac disease and the basic information all said the same thing - no gluten. However, I didn't see any reference to dairy products. Milk is commonly known to cause GI problems for a number of people so it would be prudent to avoid milk in someone with celiac disease if you don't know anything else about them. On the other hand, celiac disease is due to gluten intolerance, not lactose intolerance, and chosing to not include milk could indicate that the student didn't understand what celiac disease was.

I wonder if the student's text made a point about dairy products in celiac patients. One person on the previous discussion noted that some celiac patients do have trouble with dairy products but I'm wondering if the average nurse who doesn't commonly work with celiac patients should be aware of that. Anyone have insight on this? Thanks!

[Esther2007]

Celiac patients require vitamin A, D and k, so since milk contains Vitamin D, I believe it will be ok.

[Finallyat40]

celiac disease....however, you are correct about milk being known to be hard on the GI tract....I think that's where they were trying to catch you. I know two people with celiac who absolutely could not live without their vanilla ice cream....because they can't have gluten (cakes, pies, desserts), ice cream is their treat.

Jamie

[Jolie, BSN]

Read up on the pathophysiology of Celiac disease.

When a patient with Celiac disease ingests gluten it causes the upper layers of the intestinal tract to become denuded. Lactose is absorbed by these upper layers of the gi tract, so when a patient has a Celiac "flare-up" his/her ability to digest milk is affected. This is NOT a true lactose intolerance, since most Celiac patients tolerate milk just fine when their intestines are not damaged by gluten.

If a patient is experiencing an acute Celiac "flare-up", he/she will probably not tolerate lactose. When his gi tract has healed, he will most likely tolerate milk without any difficulty.