Celiac Disease Health Center

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Symptoms usually return any time foods with gluten are eaten. Although some people who have celiac disease may be able to eat foods that contain gluten without developing symptoms, this does not mean that the body is absorbing all nutrients normally. Even without symptoms, if the small intestine is injured from gluten, the lack of absorption of nutrients may cause complications such as iron deficiency anemia and osteoporosis.

In rare cases, people who appear to have celiac disease do not get better on a gluten-free diet. Some people get better after starting a gluten-free diet and stay better for awhile, but their symptoms come back even though they are still eating a gluten-free diet. This condition is called refractory sprue. In these cases, corticosteroids or other medicines that change the immune system response may be used to control symptoms. People who do not improve on a gluten-free diet should be tested for other conditions, including T-cell lymphoma.