Treatment, medication, a gluten-free diet

Because the key problem in celiac disease is the gut's reaction to gluten, the causative treatment for celiac disease is therefore a gluten-free diet.

Since the disease is lifelong, permanent adherence to a gluten-free diet is necessary.

Positive antibodies at diagnosis may disappear after the introduction of a gluten-free diet, so antibody testing is useful as a check on adherence to the diet. Non-adherence to a gluten-free diet may not be immediately apparent in the patient, but by that time damage to the small intestinal mucosa may already be occurring with a risk of complications.

A gluten-free diet means the complete exclusion of foods containing:

• wheat,
• rye,
• barley
• and oats.

Forbidden cereals can be replaced with products made of:

• maize (corn),
• soy,
• poatoes,
• rice,
• buckwheat,
• amaranth,
• sorghum,
• beans,
• nuts,
• fruits,
• vegetables,
• meat,
• eggs
• and other gluten-free products

We also exclude dairy products when starting with a gluten-free diet in patients with presenting gastrointestinal symptoms, as the current lactase deficiency (lactose intolerance) accentuates the present intestinal symptomatology.

Once the gluten-free diet is in place, as the condition improves, we can start to gradually add dairy products - taking into account the individual patient's tolerance. A stabilised patient usually tolerates dairy products well.

It is also necessary in some cases to substitute vitamins or certain minerals, especially iron or calcium, at the beginning of treatment.

Some gluten-free foods and ingredients are currently covered by health insurance.

A small percentage of patients with celiac disease do not respond to a gluten-free diet. In these patients, immunosuppressive therapy in the form of corticosteroids may help.

Alcohol is not banned in celiac disease, but its harmfulness is the same as in healthy people.

It is to be consumed in small quantities. Distillates and grapes are gluten-free and allowed, the problem arises with beer, which contains gluten.

It's good to know that just because you don't feel any problems (e.g. after a beer) doesn't mean that there is no damage to the small intestine.