Living Positively with Celiac Disease
How is celiac disease treated?
Treatment for celiac disease is both simple and challenging. Those with the disease must maintain a strict gluten-free diet for life. By avoiding gluten, you allow your intestine to heal. Your other symptoms should gradually subside and your risk of developing serious complications of untreated celiac disease will be reduced.
Going gluten-free can be challenging because it requires you to educate yourself about foods that contain gluten, to watch for “hidden” gluten in food products and medications, and to give up a number of common foods you may enjoy. Start your treatment for celiac disease by reviewing this partial list of where gluten can be found:
• Most breads and baked goods (e.g., muffins, donuts, cakes)
• Many other grains, including spelt and kamut
• Most breakfast cereals
• Most pasta
• Some soups, sauces and salad dressings
• Some processed meats and fish (e.g., wieners, imitation seafood)
• Most beer (which contains barley)
• Some cosmetic products
• Some condiments.
Fortunately, the world has become a much friendlier place for people who can’t eat glutenand treatment for celiac disease is much easier than it has been in the past. In fact, in 2009 the gluten-free diet became the # 1 “speciality diet” in North America. Grocery stores stock an increasing number and variety of gluten-free products, including gluten-free versions of pasta, bagels, crackers, pretzels, and other baked goods. Be sure that these products are nutritionally sound before using them. Gluten-free options are also gaining ground in restaurants, cookbooks and cooking websites.
Once you’ve been diagnosed with celiac disease, ask your doctor to refer you to a registered dietitian with expertise in treatment for celiac disease and nutritional counselling. Your local chapter or the national office of the Canadian Celiac Association can also provide excellent resources about diagnosis and management. You will most likely need to start Vitamin D and may also require extra iron and multivitamins until your intestine heals.
You should get follow-up blood testing to verify that your intestines are healing. This will be done ideally 3-6 months after you’ve started a gluten-free diet and every 1-2 years after that. Some, but not all people, require a repeat intestinal biopsy.
Adults living with celiac disease who have symptoms of malabsorption (such as diarrhea, weight loss, or anemia) or bone pain need a bone mineral density (BMD) test at diagnosis and annually afterwards until the problem is resolved. You should also request BMD testing if you are a woman at menopause or a man over age 50. Children’s bones heal rapidly and most do not require a BMD.
Managing celiac disease
There is no reason to restrict your social activities if you have celiac disease. As previously noted, many restaurants now offer gluten-free options. You don’t need to be shy to ask waiters about modifying dishes to meet your health requirements.
You can also prepare for restaurant outings by checking out their online menus. If you know that gluten-free choices won’t be available, you can eat before going out, bring gluten-free snacks with you or choose a more appropriate restaurant.
Keeping tabs on your overall health, especially the possible complications of celiac disease, can help put your mind at rest and manage problems before they get serious.
For example, it’s a good idea to have regular screening tests for osteoporosis. If a test shows you have strong bones, it’s one less thing for you to worry about. If your bones show signs of weakening, you and your doctor can begin a treatment plan, which could include calcium, vitamin D supplements, and possibly prescription medications.
Celiac disease has a strong presence in the digital world. Take advantage of discussion forums, support groups, and gluten-free apps for smart phones and tablets. Some of them have food databases you can search to find gluten-free products and menu options.
Finally, being open with family and friends can help them accommodate your dietary needs. If you feel uncomfortable divulging details about your personal health, you can give people this guide to read.
Gluten-free cooking tips
The following tips can make your life easier in the kitchen:
- Start with recipes that include very little flour or other gluten-containing ingredients. Then omit those ingredients or use gluten-free substitutes instead.
- Choose old-fashioned recipes that involve preparing dishes “from scratch” rather than using convenience foods.
- Learn to make basic sauces and gravies used in soups and casseroles.
- Use herbs and spices for flavouring. In Canada, spices are gluten-free but seasonings may contain gluten.
- Invest in a gluten-free cookbook.
- Use gluten-free macaroni, bread, and corn tortillas.
- Serve lean protein (e.g., chicken breast, fish, eggs, low-fat cheese), vegetables and fruits while developing your celiac-friendly cooking skills.
- Check out our 7 day gluten free diet plan!