Category: Gluten-free Diet

1. How long does it take for the rash to clear after beginning a gluten-free diet?
2. Is it safe to assume that if I eat something with gluten in it I will get a rash soon after?
3. Why is it necessary for DH sufferers to be on a gluten-free diet?
4. Can a food be gluten-free when barley malt extract is listed among the ingredients?

1. How long does it take for the rash to clear after beginning a gluten-free diet?
   
   It is important to appreciate that a gluten-free diet may have no effect on the rash for approximately six months and sometimes, even longer. It takes this length of time before patients can start to reduce their drug requirements and approximately 2 years before they can discontinue drugs completely. It is also important to realize that these times are only achieved if the diet is absolutely strict. Even small amounts of gluten may result in patients not being able to stop their drugs.
   
   (Source - Medical Article)
   
   
   
   
2. Is it safe to assume that if I eat something with gluten in it I will get a rash soon after?
   
   The reappearance of spots in DH sufferers is an unreliable indicator of gluten intake. The general rule is the longer a person is gluten-free the longer it takes for the rash to present when gluten is, once again, consumed. One study showed that 12 weeks was the average time for the rash to recur in patients who had been gluten-free for periods ranging from 3-12 years.
   
   There appear to be some DH sufferers who, despite being on a gluten-free diet, have to continue on a maintenance dose of dapsone. There are also a small group of coeliacs who don't respond to a gluten-free diet, but they are a very small minority. There continues to be a lot to learn about DH and CD, even today.
   
   (Source - Forum Contributors)
   
   
   
   
3. Why is it necessary for DH sufferers to be on a gluten-free diet?
   
   Until the discovery of the association of DH with coeliac disease the treatment of DH was solely with drugs. Whilst the drugs will suppress the rash within days they do not heal the damage to the intestine caused by coeliac disease. It is hoped that most sufferers will be able to reduce and eventually stop taking the drugs after some time on a strict gluten-free diet. The diet also gives some protection against developing associated DH/CD disorders.
   
   (Source - Medical Article)
   
   
   
   
4. Can a food be gluten-free when barley malt extract is listed among the ingredients?
   
   Malt is produced by steeping barley in water and allowing it to germinate or spout. This process is stopped by the use of heat and the resulting malt is not gluten-free.
   
   Malt extracts are obtained from malted barley using a further process in which the products of malt that are soluble in water, are extracted. This extract contains a small amount of protein, but it has never been shown to be harmful to coeliacs and DH sufferers. Malt extract is commonly used in the food industry as a flavour enhancer and as such is used in very small quantities. This is allowed, in the UK, on a gluten-free diet but in the light of current knowledge, coeliacs and people with dermatitis herpetiformis are advised to avoid products which contain a high percentage of malt extract, such as pure malt extract and malted drinks.
   
   (Source - Coeliac UK)