The gluten-free diet is a lifetime requirement. Eating any gluten-containing food, no matter how small an amount, can damage the intestine. This is true for anyone with the disease, including people who do not have noticeable symptoms. It can take weeks for antibody levels (indicating intestinal damage) to normalize after a person with celiac disease has consumed gluten. Depending on a person’s age at diagnosis, some problems, such as delayed growth and tooth discoloration, may not improve.
A gluten-free diet means avoiding all foods that contain wheat (including spelt, triticale, and kamut), rye, and barley. Despite these restrictions, people with celiac disease can eat a well-balanced diet with a variety of foods, including gluten-free bread and pasta. For example, instead of wheat flour, people can use potato, rice, soy, or bean flour.
Unprocessed meat, fish, rice, fruits, and vegetables do not contain gluten, so people with celiac disease can eat these foods. The gluten-free diet requires a completely new approach to eating that affects a person’s entire life. People with celiac disease have to be extremely careful about what they buy for lunch at school or work, eat at cocktail parties, or grab from the refrigerator for a midnight snack. Eating out can be a challenge as the person with celiac disease learns to scrutinize the menu for foods with gluten and question the waiter or chef about possible hidden sources of gluten. However, with practice, identifying potential sources of gluten becomes second nature and people learn to recognize which foods are safe and which are off limits.
A dietitian, a health care professional who specializes in food and nutrition, can help people learn about their new diet. It is important to find a dietitian who specializes in celiac disease. You can find one at www.EatRight.org. Also, support groups are particularly helpful for newly diagnosed people and their families as they learn to adjust to a new way of life. If you find that the diet is still difficult after several months, or you are still sick, talk to your doctor, your dietitian, and your support organizations. You may be eating gluten accidentally and need an outside perspective to identify foods that are keeping you from regaining your health.