A Closer Look at Treating Celiac Disease

Medically Reviewed By William C. Lloyd III, MD, FACS
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When you have celiac disease, your body has an abnormal reaction to gluten. That's a protein in wheat, rye and barley. If gluten gets into your digestive system, your immune system will attack part of your small intestine. That causes inflammation. This type of misfire by the immune system is known as an autoimmune reaction. 

Celiac Disease Symptoms and Intestinal Damage

Celiac disease can start at any age. It affects about 1% of the population. It may be triggered by surgery, stress, a viral infection, or pregnancy. Common symptoms in children include bloating, diarrhea, constipation, belly pain, and weight loss. Common symptoms in adults include fatigue, joint pain, depression, tingling, canker sores, and skin rash

Celiac disease is like a one-two punch. You can get symptoms from the initial attack of inflammation when you eat gluten. Then, with time, repeated attacks can damage your small intestine. 

Damage occurs to the tiny, finger-like projections that line the small intestine, called villi. You need those villi to absorb important nutrients from the food you eat. Damage to the villi can lead to malnutrition. That, in turn, can cause anemia and weak bones. 

Understanding Treatment for Celiac Disease

Celiac disease is a lifelong disease. The only treatment is a gluten-free diet. Once you eliminate foods with gluten from your diet, the attacks should stop in a few days. 

For children with celiac disease, damage to villi in the small intestine usually heals within six months. For adults, healing may take several years. 

You should not need medications to treat celiac disease. But, you might need to take iron, calcium, and vitamin D to catch up on lost nutrients. You also might need to take other vitamins to make up for any nutrients missing in your new gluten-free diet. 

About 5% of people with celiac disease don't get relief from a gluten-free diet. They have a condition called refractory celiac disease. It can occur in people with a severely damaged small intestine, which cannot heal.  People with this condition may need to take steroids and drugs that suppress the immune system. 

Gluten-Free Diet Basics

You can still eat plenty of fresh foods like fish, meat, vegetables and fruit on a gluten-free diet. Flour made from rice, quinoa or beans is also safe. So are the grains and the beans themselves. Also, many supermarkets now have gluten-free sections, so finding variety on a gluten-free diet is much easier than it used to be.  

Here are gluten sources to avoid: 

  • Common wheat-based foods, such as breads, baked goods, pasta, and cereals. Wheat may also go by other names, like farina and spelt. Hidden wheat sources include some sauces and even salad dressings.Common barley sources, such as beer, malt vinegar, soups, and food coloring.
  • Common rye sources, such as breads, beer and cereals.
  • Triticale, a new grain on the market. It's similar to wheat and is in some breads, pastas and cereals. 
  • Many processed foods. Examples include bouillon cubes to make broth, candy, chips, cold cuts, sausages, self-basting turkey, gravy, soy sauce, and matzo. 

Consider working with a nutritionist to learn more about following a gluten-free diet. 
Besides food, gluten is also in some medicines, vitamins, and even lip balms. Read the label on everything that goes into—or onto—your mouth. Ask your pharmacist if you’re in doubt about a product. 

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Oct 16
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

  1. Celiac Disease, National Digestive Diseases Information Clearinghouse (NDDIC). http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/

  2. What Is Celiac Disease? Celiac Disease Foundation.  http://celiac.org/celiac-disease/what-is-celiac-disease/

  3. Treatment and Follow Up, Celiac Disease Foundation. http://celiac.org/celiac-disease/treating-celiac-disease/

  4. What Is Gluten? Celiac Disease Foundation.  http://celiac.org/live-gluten-free/gluten-free-diet/what-is-gluten/