Coeliac disease treatment

What is the treatment for coeliac disease?

The main treatment for coeliac disease is to cut out food and drink containing gluten.

Following a gluten-free diet helps prevent coeliac disease symptoms, including diarrhoea and stomach pain.

Gluten-free diet

A gluten-free diet includes avoiding all foods made from wheat, rye, and barley. Examples are breads, cereals, pasta, crackers, cakes, pies, biscuits and gravies.

Some people with coeliac disease can tolerate oats in the diet. But some oat preparations can be contaminated with wheat. Thus, it is probably best to avoid oats at least during the initial treatment with a gluten-free diet. Once disease remission is achieved with a strict gluten-free diet, small quantities of oats can be reintroduced into the diet under medical supervision.

Pay attention to processed foods that may contain gluten. Wheat flour is a common ingredient in many processed foods. Examples of foods that may contain gluten, to name only a few, include:

• Tinned soups
• Salad dressings
• Ice cream
• Chocolate bars
• Instant coffee
• Cooked sliced meats
• Ketchup
• Mustard
• Processed and tinned meats
• Yoghurt
• Sausages
• Pasta

Other tips include:

• Beware of tablets, capsules, and vitamin preparations that contain gluten. Wheat starch is commonly employed as a binding agent in tablets and capsules. Gluten also can be found in many vitamin products and cosmetic products such as lipstick.
• Avoid beer.
• It is all right to drink (in moderation) wine, brandy, whisky and other non-wheat or barley alcohol.
• Avoid milk and other dairy products that contain lactose. Untreated patients with coeliac disease often are lactose intolerant. With successful treatment, dairy products can be reintroduced slowly into the diet later.
• It is alright to consume fish, fresh meats, rice, corn, soya beans, potato, poultry, fruit, vegetables and dairy products (for patients who are not lactose intolerant).
• Consult a dietitian or an organisation such as Coeliac UK for lists of gluten-free foods.

Read the food and product labels before buying or consuming any product. This is necessary because a manufacturer may change a product's ingredients at any time. A product that was gluten-free in the past may now contain gluten. Even branded products may be gluten free in one country but contain gluten in another country. If you are not certain after reading the labels, contact the manufacturer.

Supplements

Because patients with severe malabsorption can develop vitamin and mineral deficiencies, vitamin and mineral supplements may be recommended particularly for the first 6 months of treatment. Patients with iron deficiency anaemia should be treated with iron. Patients with anaemia due to folate or B12 deficiency should be treated with folic acid and B12. Patients with an abnormal clotting times should be treated with vitamin K. Patients with low blood calcium levels or with osteoporosis should be treated with calcium and vitamin D supplements.