The only treatment for celiac disease presently is a strict gluten free diet for life. There is no medication needed except for supplements for nutrition deficiencies, which need to be taken for 6-12 months after diagnosis.
The intestine starts healing almost immediately after gluten is removed from the diet though it may take up to two years for it to heal completely. As the intestines start to recover, there is visible improvement in symptoms within 2-4 weeks, especially gastrointestinal symptoms.
tTG value too starts to reduce, though it may take 2 years to normalize. One must remember however, that a normal tTG value does not mean that the individual has been cured but only that the disease is under control with gluten free diet. These patients, their family and friends do deserve a pat on their back but does not give them a green signal to restart gluten!
Compliance to a strict gluten free diet is thus critical. Accidental or frequent ingestion of even small amounts of gluten can cause short term symptoms and long term damage. Read some of our patients’ experiences with non-compliance to the diet. In rare instances, refractory celiac disease occurs where the intestine does not heal despite all precautions.
Follow-up visits are thus essential to evaluate the response to gluten free diet. Follow-ups are recommended after 2 weeks, 3 months, 6 months of diagnosis and thereafter annually. Refer to the gluten free health card for the tests which one must undergo at the time of follow-up and for keeping track of one’s health.
Biopsy need not be repeated if the individual is doing well on gluten free diet. Only in certain cases – where the diagnosis was not clear, response is not as expected or the diagnosis had taken place before the age of 2 years – the doctor may consider repeating the biopsy.
Gluten (meaning glue in Latin) is a storage protein found in several grains. Gluten found in the three grains – wheat, barley and rye is antigenic and responsible for the development of celiac disease. About 5-10% of the celiac disease population also reacts to the storage protein found in oats in the same way as they do to gluten of wheat, barley and rye.
20 parts per million, i.e. 20 mg of gluten per kg of food, is the generally accepted limit of gluten in ‘gluten free’ labelled food items in most parts of the world.
‘Which food items are safe and which are not?’ is the most critical question for individuals with celiac disease and for their families. The good news is that 3 out of 4 basic food groups are completely safe for a gluten free diet. The bad news – that wheat finds its way in many food items, especially packaged products.
Except wheat, barley, rye, oats and their hybrid grains, all naturally occurring food items are inherently gluten free. This would make many food items which you are eating presently gluten free in their natural form. Some of these items are listed below.
*Flours and/or starches made out of these.
Gluten can be present in a food product in many ways:
Source: Celiac India
Last Modified : 2/12/2020
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