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Celiac Disease
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Treatment For Celiac Disease
The only treatment for Celiac (pronounced - SEL-ee-ak) disease is to follow a gluten-free diet. When a person is first diagnosed with celiac disease, the doctor usually will ask the person to work with a dietitian on a gluten-free diet plan. A dietitian is a health care professional who specializes in food and nutrition. Someone with celiac disease can learn from a dietitian how to read ingredient lists and identify foods that contain gluten in order to make informed decisions at the grocery store and when eating out.
For most people, following this diet will stop symptoms, heal existing intestinal damage, and prevent further damage. Improvements begin within days of starting the diet. The * small intestine is usually completely healed in 3 to 6 months in children and younger adults and within 2 years for older adults. Healed means a person now has villi that can absorb nutrients from food into the bloodstream.
In order to stay well, people with celiac disease must avoid gluten for the rest of their lives. Eating any gluten, no matter how small an amount, can damage the small intestine. The damage will occur in anyone with the disease, including people without noticeable symptoms. Depending on a person's age at diagnosis, some problems will not improve, such as delayed growth and tooth discoloration.
Some people with celiac disease show no improvement on the gluten-free diet. This condition is called unresponsive celiac disease. The most common reason for poor response is that small amounts of gluten are still present in the diet. Advice from a dietitian who is skilled in educating patients about the gluten-free diet is essential to achieve the best results.
Rarely, the intestinal injury will continue despite a strictly gluten-free diet. People in this situation have severely damaged intestines that cannot heal. Because their intestines are not absorbing enough nutrients, they may need to receive nutrients directly into their bloodstream through a vein, or intravenously. People with this condition may need to be evaluated for complications of the disease. Researchers are now evaluating drug treatments for unresponsive celiac disease.
The web contains information about celiac disease, some of which is not accurate. The best people for advice about diagnosing and treating celiac disease are one's doctor and dietitian.
The Gluten-free Diet
A gluten-free diet means not eating foods that contain wheat (including spelt, triticale, and kamut), rye, and barley. The foods and products made from these grains are also not allowed. In other words, a person with celiac disease should not eat most grain, pasta, cereal, and many processed foods. Despite these restrictions, people with celiac disease can eat a well-balanced diet with a variety of foods, including gluten-free bread and pasta. For example, people with celiac disease can use potato, rice, soy, amaranth, quinoa, buckwheat, or bean flour instead of wheat flour. They can buy gluten-free bread, pasta, and other products from stores that carry organic foods, or order products from special food companies. Gluten-free products are increasingly available from regular stores.
Checking labels for "gluten free" is important since many corn and rice products are produced in factories that also manufacture wheat products. Hidden sources of gluten include additives such as modified food starch, preservatives, and stabilizers. Wheat and wheat products are often used as thickeners, stabilizers, and texture enhancers in foods.
"Plain" meat, fish, rice, fruits, and vegetables do not contain gluten, so people with celiac disease can eat as much of these foods as they like. Recommending that people with celiac disease avoid oats is controversial because some people have been able to eat oats without having symptoms. Scientists are currently studying whether people with celiac disease can tolerate oats. Until the studies are complete, people with celiac disease should follow their physician's or dietitian's advice about eating oats. Examples of foods that are safe to eat and those that are not are provided below.
The gluten-free diet is challenging. It requires a completely new approach to eating that affects a person's entire life. Newly diagnosed people and their families may find support groups to be particularly helpful as they learn to adjust to a new way of life. People with celiac disease have to be extremely careful about what they buy for lunch at school or work, what they purchase at the grocery store, what they eat at restaurants or parties, or what they grab for a snack. Eating out can be a challenge. If a person with celiac disease is in doubt about a menu item, ask the waiter or chef about ingredients and preparation, or if a gluten-free menu is available.
Gluten is also used in some medications. One should check with the pharmacist to learn whether medications used contain gluten. Since gluten is also sometimes used as an additive in unexpected products, it is important to read all labels. If the ingredients are not listed on the product label, the manufacturer of the product should provide the list upon request. With practice, screening for gluten becomes second nature.
The Gluten-free Diet: Some Examples
In 2006, the American Dietetic Association updated its recommendations for a gluten-free diet. The following chart is based on the 2006 recommendations. This list is not complete, so people with celiac disease should discuss gluten-free food choices with a dietitian or physician who specializes in celiac disease. People with celiac disease should always read food ingredient lists carefully to make sure that the food does not contain gluten.
Allowed Foods:
- Amaranth
- Arrowroot
- Buckwheat
- Cassava
- Corn
- Flax
- Indian rice grass
- Job's tears
- Legumes
- Millet
- Nuts
- Potatoes
- Quinoa
- Rice
- Sago
- Seeds
- Soy
- Sorghum
- Tapioca
- Wild Rice
- Yucca
Foods To Avoid:
- Wheat
- Including einkorn, emmer, spelt, kamut
- Wheat starch, wheat bran, wheat germ, cracked wheat, hydrolyzed wheat protein
- Barley
- Rye
- Triticale (a cross between wheat and rye)
Other Wheat Products:
- Bromated flour
- Durum flour
- Enriched flour
- Farina
- Graham flour
- Phosphated flour
- Plain flour
- Self-rising flour
- Semolina
- White flour
Processed Foods That May Contain Wheat, Barley, or Rye
(Most of these foods can be found gluten-free. When in doubt, check with the food manufacturer)
- Bouillon cubes
- Brown rice syrup
- Chips / potato chips
- Candy
- Cold cuts, hot dogs, salami, sausage
- Communion wafer
- French fries
- Gravy
- Imitation fish
- Matzo
- Rice mixes
- Sauces
- Seasoned tortilla chips
- Self-basting turkey
- Soups
- Soy sauce
- Vegetables in sauce
For a complete copy of the Celiac Disease Nutrition Guide, visit www.eatright.org
Definitions For This Page - In Alphabetical Order
* Small Intestine
The small intestine is the organ where most digestion occurs. It measures about 22 feet and includes the duodenum, jejunum, and ileum. The duodenum is the first part of the small intestine, right after your stomach, jejunum is the middle section of the small intestine between the duodenum and ileum, and the ileum is the lower end of the small intestine. More about Small Intestine.
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References:
National Digestive Diseases Information Clearinghouse (NDDIC)
NIH Publication No. 07-4269
August 2007
digestive.niddk.nih.gov
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