Lifestyle Changes to Manage Celiac Disease

Gluten-free Diet

A lifelong, gluten-free diet is the only treatment for celiac disease. Fortunately, it is extremely effective. Symptoms often go away within days of starting the diet. (Some symptoms, such as certain dental problems, may be permanent). Complete healing, however, of damaged villi lining the intestines may take months or years.

Additional intake of gluten can damage the intestine, even if you have no symptoms. Nutritional supplements, given intravenously, may be needed if the intestinal damage is significant and does not heal.

Since gluten is present in many foods (eg, bread and pasta) and it is often an additive to many foods, the diet can be complicated and frustrating. Many patients seek the help of a dietitian in meal planning. Some patients find support groups helpful.

Foods to Avoid

To follow a gluten-free diet, you must avoid all foods containing:

• Wheat
• Rye
• Barley
• Oats (in most cases)

This list includes most bread, pasta, cereal, and processed foods. Special gluten-free breads and pastas are available. They are made with potato, rice, soy, or bean flour.

Doctors are still uncertain as to whether people with celiac disease must avoid all foods containing oats. Research is currently underway to answer this question. Until these studies are completed, ask your doctor for advice about eating oats. Many people with celiac disease also become lactose intolerant. If you are lactose intolerant, you may also need to avoid milk products. In some people, lactose intolerance resolves after following a gluten-free diet.

Managing the Diet

Maintaining a gluten-free diet requires a lot of vigilance since gluten is included in many unexpected foods and beverages. When buying processed and packaged foods, carefully read all labels. If you are unsure if a food contains gluten, don’t eat it until you find out definitively. Calling the manufacturer of the food can sometimes be helpful in this regard.

A short (but by no means exhaustive) list of other foods that contain gluten include:

• Flavored coffee
• Beer
• Tuna in vegetable broth
• Packaged rice mixes
• Some frozen potatoes
• Creamed vegetables
• Commercially prepared vegetables, salads, and salad dressings
• Pudding
• Some ice cream

Ordering at restaurants can also be challenging since many foods on the menu may contain gluten. Rather than shying away from eating at restaurants, however, call ahead and see if you can get details on what ingredients they use in their foods. Many restaurants will be cooperative in this regard.