The treatment for celiac disease is a strict gluten-free diet, which includes:

• Avoiding all foods with wheat, barley, rye, or oats. Oats may later be gradually reintroduced into the diet.
• Not drinking beer, even nonalcoholic versions.
• Eating meals that include rice, corn, millet, and buckwheat.

Most people with the disease who adopt this diet permanently and consistently do not develop health problems associated with celiac disease. If nutritional deficiencies are present, other treatments may be needed, such as vitamin, iron, and calcium supplements.

Initial treatment

When celiac disease is diagnosed, you should immediately adopt a strict gluten-free diet. Eating even the smallest amount of gluten can cause symptoms such as weight loss and diarrhea. You may be advised to temporarily avoid milk or milk products until your intestine heals, at which time you usually can gradually reintroduce them. A registered dietitian can help you learn how to incorporate this diet and its restrictions. Most people also find local and national celiac disease support groups helpful. For more information, see the Other Places to Get Help section of this topic.

Within 2 weeks after starting a gluten-free diet, 70% of people with celiac disease find their symptoms improve.⁴ Symptoms should completely disappear within 3 months. However, it takes 2 to 6 months or longer on a gluten-free diet for the tiny, fingerlike, raised tissues (villi) of the small intestine to return to normal.

Some children with untreated celiac disease become very sick and require hospitalization. Usually, they recover quickly after treatment with fluids and medications. A gluten-free diet usually prevents these symptoms from returning.

Ongoing treatment

A gluten-free diet usually will eliminate symptoms of celiac disease and prevent long-term damage to the small intestine or other complications.

Although symptoms of the disease are controlled by adopting a gluten-free diet, you should see a health professional yearly for monitoring. A child especially needs to be watched for:

• Delayed growth. Children with celiac disease do not absorb needed nutrients if they eat gluten. This may result in delayed growth if gluten is eaten regularly over a long period. The vast majority of children catch up in growth unless diagnosis is delayed beyond puberty.
• Nutritional deficiencies. Eating gluten also can lead to an imbalance of chemicals, minerals, and vitamins. These deficiencies should reverse with a gluten-free diet, but vitamins, iron, or calcium supplements are sometimes needed.
• Tumors. As children who have celiac disease grow into adulthood, they may be at a slightly increased risk for developing cancer (lymphoma) in the small intestine and the esophagus, although the evidence for this is not clear. However, one study has found that following a gluten-free diet for 5 years lowers the risk for lymphoma to that of the non-celiac population.³

Treatment if the condition gets worse