From the Guidelines
The primary treatment for celiac disease is a strict, lifelong gluten-free diet, as recommended by the most recent and highest quality study 1. This means completely avoiding foods containing wheat, barley, and rye, as these grains contain the protein gluten that triggers the immune response in celiac patients. There are no medications that cure celiac disease. The gluten-free diet allows the small intestine to heal and prevents further damage. Patients should eliminate obvious sources of gluten like bread, pasta, and cereals made with prohibited grains, but must also be vigilant about hidden gluten in processed foods, sauces, and even medications. Some key points to consider when implementing a gluten-free diet include:
- Avoiding foods containing wheat, barley, and rye
- Being mindful of hidden gluten in processed foods and medications
- Considering the introduction of pure oats, but with careful monitoring for adverse reactions 1
- Regular follow-up with healthcare providers to monitor healing and nutritional status
- Potential need for nutritional supplements, such as iron, calcium, vitamin D, zinc, and B vitamins, to correct deficiencies caused by intestinal damage Regular follow-up with healthcare providers is important to monitor healing and nutritional status. Most patients experience significant symptom improvement within weeks of starting the diet, though complete intestinal healing may take months to years. The strict dietary approach is necessary because even small amounts of gluten can trigger inflammation and damage in celiac patients, perpetuating symptoms and increasing long-term health risks. Additionally, a gluten-free diet has been shown to have several benefits, including improvements in bone mineral density and nutritional parameters, as well as a reduced risk of non-Hodgkin’s lymphoma 1. It is also important to note that patients with celiac disease may require ongoing monitoring and support to ensure adherence to the gluten-free diet and to address any potential nutritional deficiencies or other complications that may arise 1.
From the Research
Celiac Disease Treatment Overview
- The only effective and safe treatment of celiac disease is a strict lifelong gluten-free diet (GFD) 2, 3, 4, 5.
- A GFD helps control signs and symptoms, prevents complications, and promotes mucosal healing in the small intestine 4, 5.
Gluten-Free Diet Characteristics
- The diet must eliminate gluten as an ingredient, as well as hidden components and potential cross-contamination in foods 2, 4.
- A balanced GFD should be based on a combination of naturally gluten-free foods and certified processed gluten-free products 2.
- Nutritional education by a trained nutritionist is crucial to achieve long-term satisfactory health status and good compliance 2.
Challenges and Limitations of Gluten-Free Diet
- Strict adherence to the GFD can be challenging due to concerns about social isolation, risk of gluten contamination, high cost, and poor quality of gluten-free products 3, 4.
- The GFD may lead to dietary imbalances due to nutrient deficiencies over a long period of time 3, 6.
- Alternative therapies are being explored to improve treatment efficacy and quality of life for patients with celiac disease 3, 4, 5.
Emerging Therapies and Strategies
- Novel therapies, such as glutenases, polymers, and vaccine development, are being developed to induce tolerance towards gluten or degrade ingested gluten 4, 5.
- Clinical drug trials are expected to begin soon, including in children 5.
- Technology advancements and follow-up strategies are being investigated to improve adherence to the GFD and monitor potential transgressions 3.