Treatment and Support
The gluten-free diet (GFD)
Taking on the gluten-free diet may feel like a lot at first. Don’t be afraid to reach out for help and support from your gastroenterologist, dietitian or local support group. Educating yourself and knowing what foods you can have will be the key to staying gluten-free and feeling healthy.
Here are a few tips as you take on your gluten-free diet:
- The main offenders
- These items have gluten and are used in many common food items, even as thickeners or fillers for sauces, condiments and more. These should always be avoided:
- Brewer’s yeast.
- Oats (unless they are pure, uncontaminated, labeled gluten-free oats and your doctor has said you are able to eat them).
- Yeast extract and autolyzed yeast extract (avoid unless a non-gluten source is indicated on the label).
- Eat balanced!
- Fruits and veggies (fresh, frozen or canned without sauces or flavors); plain meat, fish, and poultry; plain nuts and seeds; oils; and most milk products are all naturally gluten-free.
- Stock up on these for snacks and meals to make sure you are getting all the nutrients you need.
- Just like a diet without any limits, eating a balance of each food group will help to keep you healthy.
- No need to skip the starch
- There are plenty of gluten-free grains and starches you can eat. Remember, whole grains are part of a balanced diet, too. These can be consumed on a GFD:
- Sweet potatoes.
- Try some of these higher fiber, nutritious gluten-free grains and starches that act like grains:
- Make sure they are labeled gluten-free!
- Gluten-free replacements
- If it is labeled “gluten-free,” it is safe to eat.
- There are many gluten-free replacements for common snacks and foods like crackers, cereal, pasta, baking mixes and more.
What successful treatment looks like
Being healed from celiac disease means that your small intestine starts to work as it should again and can start taking in nutrients the right way; but, it does not mean that you are able to eat gluten.
While you will never be fully cured of celiac disease, meaning you will always have the disease, after eating a GFD, your small intestine usually heals within two years for adults and within a few months in children and young adults.
Your gastroenterologist may want to take another biopsy (taking a small piece of tissue to look at under a microscope) about one to two years after you start to make sure your new diet is helping.
The National Institutes of Health suggests these points to keep in mind as you care for your celiac disease:
– Consultation with a skilled registered dietitian (RD)
- Ask your GI doctor for a recommendation.
- Perform a Google search for registered dietitians in your area who specialize in celiac disease.
– Education about celiac disease
- Get and stay informed! Trusted websites, like government sites, can give you great information.
– Lifelong adherence to a GFD
- Even a little bit of gluten can go a long way in terms of harming your gut. Learn the best ways to eat gluten-free while still keeping up your daily routines.
– Identification and treatment of nutritional deficiencies
- This means having routine health exams so you doctor can check blood levels of certain vitamins, minerals and nutrients.
– Access to a support group
- There are plenty of community groups that focus on celiac disease. Reach out and get connected!
– Continuous long-term follow-up by a multidisciplinary team
- Since celiac disease stays with you your whole life, you need to create a good, long-term relationship with you doctor and dietitian. Be open with them about symptoms, questions or concerns.
Still having symptoms?
It can be scary to keep having symptoms, even after changing to a GFD. There are a few courses of action to think over when this is the case:
- Are you still eating gluten while on the gluten-free diet? Remember, even a little bit of gluten can have a harmful impact.
- Are you possibly consuming hidden gluten?
- A dietitian can help you find out if you are unintentionally consuming gluten through such things as medications, supplements or other sources.
If the answer is no to these questions and you have been on a GFD for at least six months, it is time to meet again with your gastroenterologist to find out if more tests or treatment options are needed.
Try a symptom tracker, like the MyGIHealth® app, to note your symptoms and when they occur.
Dining out gluten free
Celiac disease should not stop you from eating out. There are more new gluten-free choices each day, so start exploring! Here are a few tips to keep in mind when eating out:
- Know the gluten-free diet (GFD)!
- Be sure you have solid knowledge of labels and what you can safely eat.
- Don’t forget about hidden gluten in salad dressings, soups and marinades.
- Let your server (or host) know.
- Speak up! Make sure they know you cannot have items with gluten or that have been contaminated with gluten.
- Ask questions.
- Not sure how a menu item is made? Ask your server to ask the kitchen staff. Better safe than sorry!
- Don’t see a gluten-free menu right away? Try asking! They may have one that you need to request.
- Send it back (if you need to).
- Mistakes happen and that is OK. However, if the staff makes a mistake and adds gluten to your dish (such as putting croutons in your salad), you need to ask for it to be fixed.
- Say thank you.
- Needing to change something is nothing to feel guilty about. Showing your thanks and kindness goes a long way.
- Do your research.
- With so many restaurants having gluten-free menus, try a quick Internet search to find new places.
There are a few religious customs that call for products with gluten. Below is a table of the most common customs and solutions if you have celiac disease.
Real Life with Celiac Disease: Troubleshooting and Thriving Gluten Free by Daniel A. Leffler and Melinda Dennis
There are a number of support groups for caregivers and patients with celiac disease. Reach out to your gastroenterologist, dietitian, local hospital or community center for more details.