Screening

To screen for celiac disease, a doctor will test for the same blood proteins discussed above—autoantibodies—in patients who don’t have symptoms. Who should be screened? People with family members with celiac disease may want to best tested, as it is hereditary and 4 to 12 percent of the relatives of someone with celiac disease will also have it.

How is it treated?

There’s only one way to treat celiac disease, and that’s with a gluten-free diet. Most people with celiac disease will begin to experience improvement of symptoms within days of eliminating gluten from their diet, but healing of the small intestine can continue for years in adults and up to six months in children. Once healed, the small intestine can absorb nutrients from food into the bloodstream; as a result, many health problems associated with celiac disease can be resolved.

To ensure improvement, it’s important that the diet is strictly gluten-free. Even small amounts of gluten, like those used in processed foods as preservatives and stabilizers or foods produced in factories that also manufacture wheat, can interfere with healing.

To make sure that the extended healing process is successful and to stay healthy, people with celiac disease need to avoid gluten for the rest of their lives. Some patients work with a dietician to learn more about eating gluten-free, including learning to read labels to recognize hidden sources of gluten. Find more information about a gluten-free diet below in “A Gluten-free Diet.”

Although a gluten-free diet successfully treats most people with celiac disease, some people do not improve with dietary changes. These cases are known as refractory celiac disease. People with this condition may receive nutrients intravenously (though a vein) because their intestines cannot absorb enough nutrients. Drugs to treat refractory celiac disease are currently being evaluated.

A Gluten-free Diet

The foundation of a gluten-free diet is to not eat foods that contain wheat, rye, and barley. Foods that contain wheat, rye, and barley—in other words, gluten—include many grains, standard pastas, cereals, and many processed foods. Some grains, however, don’t contain gluten (quinoa, for example); a dietician can help you select gluten-free grains.

Although the transition to a gluten-free diet may sound dramatic, you can still enjoy a well-balanced and satisfying diet. A dietician can help you find nutritious and delicious gluten-free options. For example, instead of wheat flour, you can substitute flour made with potatoes, rice, amaranth, quinoa, buckwheat, or beans. Increasingly more gluten-free products including breads and pasta are available; find them at health-food stores and in many supermarkets.

As well, whole foods like meats, fish, fruits, and vegetables that aren’t prepared with gluten-containing products can be enjoyed on a gluten-free diet. Again, a dietician can help you find ways to prepare these foods that don’t use gluten.

In addition to assistance from a dietician and your healthcare team, you may find that reaching out to support communities for people with celiac disease (in-person and online) will help with your transition to a gluten-free life. Such groups can provide encouragement, understanding, and offer tips like recipes and how to navigate restaurant menus to make sure your selections are gluten-free.

Examples of gluten-free foods (Make sure that these foods do not come from a factory that manufactures wheat, rye, or barley.)

  • Wild rice
  • Seeds
  • Corn
  • Rice
  • Nuts
  • Buckwheat
  • Legumes
  • Potatoes

Examples of gluten-containing foods to avoid

  • WheatThis includes all varieties of wheat (such as einkorn, emmer, spelt and kamut), wheat starch, wheat bran, wheat germ, cracked wheat, and hydrolyzed wheat protein. Also, all flours that contain wheat must be avoided, meaning that plain flour, white flour, bromated flour, enriched flour, phosphated flour, self-rising flour, durum flour, farina, semolina, and graham flour are all off limits.
  • Barley (used as a whole grain or processed, such as in barley flour or flakes, and used in beer)
  • Rye (eaten whole or used in flour, rye bread, rye whisky, and some vodkas)
  • Cross-bred grain varieties, such as triticale (a cross between wheat and rye).

Examples of processed foods that may contain gluten (Read labels carefully!)

  • Soy sauce
  • Soups
  • Bouillon cubes
  • Candy
  • Brown rice syrup
  • Potato chips and all chips
  • Processed meats (hot dogs, salami, sausage, cold cuts)
  • Beer
  • Certain distilled beverages, or spirits

Resources

American Celiac Disease Alliance

American Dietetic Association

Celiac Disease Foundation

Sources

Celiac Disease. National Digestive Diseases Information Clearinghouse Web site (a service of the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health). http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/index.htm. Accessed May, 2010.
The American Dietetic Association. www.eatright.org. Accessed May, 2010.