Start on a gluten-free diet

The only treatment available

When you have biopsy-diagnosed celiac disease, you will be instructed to begin a gluten-free diet. At first, this may seem difficult, because many foods contain gluten. However, you’ll likely discover that a gluten-free diet requires creativity and planning, and that great-tasting food isn’t out of reach. Support from people with celiac disease and guidance from a skilled dietitian can be beneficial at this time.

For many people, following this diet will stop symptoms, heal existing intestinal damage, and prevent further damage. Improvements begin within weeks of starting the diet, and the small intestine is often completely healed in 6 to 18 months. Healing may take up to 2 years for older adults; for some, the gut never completely heals but heals enough to restore quality of life and prevent complications due to active celiac disease.

A well-balanced diet

A gluten-free diet means avoiding all foods that contain wheat (including spelt, triticale, and kamut), rye, and barley, and their derivatives. Despite these restrictions, you can still eat a well-balanced diet with a variety of foods, including gluten-free bread and pasta. For example, instead of wheat flour, use potato, rice, soy, corn, or bean flour. Fresh meat, fish, rice, fruits, and vegetables do not contain gluten, so you can eat as much of these foods as you want.

A lifetime commitment

The gluten-free diet is a lifetime requirement. Eating any gluten, no matter how small an amount, can damage your intestine. This is true for anyone with the disease, including people who do not have noticeable symptoms. It can take weeks for antibody levels (indicating intestinal damage) to normalize after a person with celiac disease has consumed gluten. Depending on a person’s age at diagnosis, some problems, such as delayed growth and tooth discoloration, may not improve.

The gluten-free diet requires a completely new approach to eating. You have to be extremely careful about what you buy for lunch at school or work, eat at cocktail parties, or grab from the refrigerator for a midnight snack. Eating out and traveling can be challenging as you learn to scrutinize menus for foods with gluten, question the waiter or chef about possible hidden sources of gluten, and search for safe options at airports or on the road.

However, with practice, identifying potential sources of gluten becomes second nature and you’ll learn to recognize which foods are safe and which are off limits.

The help you need

A dietitian is a healthcare professional who specializes in food and nutrition, and who can help you learn about your new diet. Also, support groups are particularly helpful as you and your family learn to adjust to a new way of life.

Over time, the diet becomes easier—even second nature.

If you find that the diet is still difficult after several months, or you are still sick, talk to your doctor, your dietitian, and your support organizations. You may be eating gluten accidentally and need an outside perspective to identify foods that are keeping you from regaining your health.

For more information

Find out about our Gluten-Free Care Package Program for people with newly biopsy-diagnosed celiac disease.

Learn more about following a gluten-free diet in the Treatment of Celiac Disease Factsheet and in the Fact or Fiction section of the Web site.

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