Treatment

NHS

Coeliac disease is usually treated by excluding foods that contain gluten from your diet. This prevents damage to the lining of your intestines and the associated symptoms, such as diarrhoea and stomach pain.

If you have coeliac disease, you must stop eating all sources of gluten for life. Your symptoms will return if you eat foods containing gluten, and it will cause long-term damage to your health.

This may sound difficult to do, but a 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 2 years for your digestive system to heal completely.

A GP will offer you an annual review during which your height and weight will be measured and your symptoms reviewed. They'll also ask you about your diet and assess whether you need any further help or specialist nutritional advice.

A gluten-free diet

When you're first diagnosed with coeliac disease, you'll be referred to a dietitian to help you adjust to your new diet without gluten. They can also ensure your diet is balanced and contains all the nutrients you need.

If you have coeliac disease, you'll no longer be able to eat foods that contain any barley, rye or wheat, including farina, semolina, durum, cous cous and spelt.

Even if you only eat a small amount of gluten, such as a spoonful of pasta, you may have very unpleasant intestinal symptoms. If you keep eating gluten regularly, you'll also be at greater risk of developing complications, such as osteoporosis and some types of cancer in later life.

Gluten is not essential in your diet and it can be replaced by other foods. There are many gluten-free versions of common foods such as pasta, pizza bases and bread available in supermarkets and health food shops. Some GPs may provide bread and bread mixes on prescription.

Many foods, such as meat, vegetables, cheese, potatoes and rice, are naturally free from gluten so you can still include them in your diet. A dietitian can help you identify which foods are safe to eat and which are not. If you're unsure, you can use the following lists as a general guide.

Foods containing gluten (not safe to eat)

If you have coeliac disease, do not eat the following foods, unless they're labelled as gluten-free versions:

  • bread
  • pasta
  • cereals
  • biscuits or crackers
  • cakes and pastries
  • pies
  • gravies and sauces

It's important to always check the labels on the foods you buy. Many foods (particularly processed foods) include additives which contain gluten, such as malt flavouring and modified food starch.

Gluten may also be found in some non-food products, including lipstick, postage stamps and some medicines.

Cross-contamination can happen if gluten-free foods and foods that contain gluten are prepared together or served with the same utensils.

Gluten-free foods (safe to eat)

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
  • fruits and vegetables
  • meat and fish (although not breaded or battered)
  • potatoes
  • rice and rice noodles
  • gluten-free flours, including rice, corn, soy and potato flour

By law, food labelled as gluten-free can contain no more than 20 parts per million (ppm) of gluten.

For most people with coeliac disease, these trace amounts of gluten will not cause a problem. However, a small number of people are unable to tolerate even trace amounts of gluten and need to have a diet completely free from cereals.

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