Coeliac disease is usually treated by simply excluding foods that contain gluten from your diet. This prevents damage to the lining of your intestines (gut) that is caused by gluten, and the associated symptoms, such as diarrhoea and stomach pain.
If you have coeliac disease, you must give up all sources of gluten for life because eating foods that contain it will cause your symptoms to return. This may sound daunting, but your GP can give you help and advice about ways to manage your diet.
Your symptoms should improve considerably within weeks of starting a gluten-free diet. However, it may take up to two years for your digestive system to heal completely. You will also need to return to your GP for regular check-ups.
A gluten-free diet
When you are first diagnosed with coeliac disease, you will be referred to a dietitian to help you adjust to your new diet without gluten. They can also ensure that your diet is balanced and contains all the nutrients you need, including essential vitamins and minerals.
If you have coeliac disease, you will no longer be able to eat any foods that contain wheat (farina, graham flour, semolina, durum cous cous and spelt ), barley or rye.
As a protein, gluten is not essential to your diet and can be replaced by other foods. Many gluten-free alternatives are widely available in supermarkets and health food shops, including pasta, pizza bases and bread. A range of gluten-free foods is also available on prescription.
Many basic foods, such as meat, vegetables, cheese, potatoes and rice, are naturally free from gluten so you can still include them in your diet. Your dietitian can help you identify which foods are safe to eat and which are not. However, if you are unsure, use the lists below as a general guide.
Foods containing gluten (to avoid)
If you have coeliac disease, do not eat the following, unless they are labelled as gluten-free:
- bread
- pasta
- cereals
- biscuits or crackers
- cakes and pastries
- pies
- gravies and sauces
It is important to always check the labels of the foods you buy. Many foods, particularly those that are processed, contain gluten in additives, such as malt flavouring and modified food starch.
Gluten may also be found in some non-food items, including lipstick, postage stamps and some types of medication.
Cross-contamination can occur if gluten-free foods and foods that contain gluten are prepared together or served with the same utensils.
Gluten-free foods (to include)
If you have coeliac disease, you can eat the following foods which naturally do not contain gluten::
- most dairy products, such as cheese, butter and milk
- fruit and vegetables
- meat and fish (although not breaded or marinated)
- potatoes
- rice
- gluten-free flours, including rice, corn, soy and potato
Coeliac UK is the country’s leading charity supporting people who are living with coeliac disease. The Coeliac UK website contains information and advice about living with the condition, including gluten-free recipes.
Other treatments
As well as eliminating foods that contain gluten from your diet, a number of other treatments are available for coeliac disease. These are described below.
Vaccinations
If you have coeliac disease, it can cause your spleen (a small an organ behind the stomach) to work less effectively, making you more vulnerable to infection from certain germs.
Therefore, you may need to have several vaccinations, including:
- flu (influenza) jab
- HIB/MenC vaccine, which protects against sepsis (blood poisoning), pneumonia (an infection of the tissue of the lungs) and meningitis (an infection of the lining of the brain)
- pneumococcal vaccine, which protects against infections caused by the Streptococcus pneumoniae bacterium
Supplements
As well as cutting gluten out of your diet, your GP or dietitian may also recommend that you take vitamin and mineral supplements, at least for the first six months after your diagnosis.
This will ensure that you get all the nutrients you need while your digestive system repairs itself. Taking supplements can also help correct any deficiencies, such as anaemia (a lack of iron in the blood).
Dermatitis herpetiformis
If you have dermatitis herpetiformis (an itchy rash that can be caused by gluten intolerance), cutting gluten out of your diet may clear it. However, sometimes it can take longer for a gluten-free diet to clear the rash than it does to control your other symptoms, such as diarrhoea and stomach pain.
If this is the case, you may be prescribed medication to speed up the healing time of the rash. It is likely that this will be a medicine called Dapsone, which is usually taken orally (in tablet form) twice a day.
Dapsone can cause side effects, such as headaches and depression, so you will always be prescribed the lowest effective dose.
You may need to take medication for up to two years to control your dermatitis herpetiformis. After this time, you should have been following a gluten-free diet long enough for the rash to be controlled without the need for medication.
