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Treating Celiac Disease

Content provided by the Faculty of the Harvard Medical School

Celiac disease will cause symptoms as long as you continue to eat gluten. If a person with celiac disease follows a strict gluten-free diet, the intestines can heal and the disease can be controlled. The good news is that the only treatment for celiac disease — a gluten-free diet — starts to work within days, and the small intestine usually heals completely within three to twelve months. However, any exposure to gluten can trigger a recurrence of symptoms (see "Do's and Don'ts of Gluten-Free Eating").

Table: Dos and Don'ts of Gluten-Free Eating

Type of food

Do not eat

Okay to eat

Grains, potatoes, flours, and cereals

wheat, rye, or barley breads, bread crumbs, pasta, or noodles; spelt, semolina, kamut, triticale, couscous, bulgur, farina; unidentified starches or fillers; most commercial cereals

gluten-free pastas and breads (made from soy, rice, corn, potato, or bean flours); plain rice, corn, popcorn, potatoes, sweet potatoes, soybeans and other beans, nuts, millet, amaranth, quinoa, oats (consult your doctor first), buckwheat, cornstarch, tapioca, and arrowroot starch; gluten-free cereals (such as corn and rice)

Fruits and vegetables

canned soups, soup mixes, bouillon cubes, creamed vegetables, most commercial salad dressings

fresh, frozen, or canned fruits or vegetables, unprocessed and without sauces; homemade soups with allowed ingredients

Meat, fish, poultry, main dishes

commercially prepared fresh or frozen meat and main dishes, lunch meats, and sausages

fresh meat, fish, poultry

Dairy products

processed cheese, cheese mixes, blue (veined) cheese; yogurt or ice cream that's unlabeled or that contains fillers or additives; low-fat or fat-free cottage cheese, sour cream, or cheese spreads

plain, natural cheese; gluten-free plain yogurt and ice cream; whole, low-fat, and fat-free milk; full-fat cottage cheese and sour cream

Alcohol

beer, ale, stout

wine, light rum, potato vodka

Other

grain or malt vinegar, commercial pudding mixes, malt from barley, soy sauce made from wheat

distilled rice, wine, or apple cider vinegar; homemade puddings from tapioca, cornstarch, rice; sugar, honey, jam, jelly, plain syrup, plain hard candy, marshmallows; gluten-free soy sauce

Oatmeal and other oat products can be problematic. Most commercial oat products used to be contaminated with wheat, barley, or rye during harvesting, transportation, storage, milling, and processing. Some companies now provide pure, uncontaminated oat products that are well tolerated by the vast majority of people with celiac disease.

People with celiac disease also need to be scrupulous to avoid cross-contamination. This happens when a gluten-free product comes into contact with something that is not gluten-free. Here are some tips for avoiding cross-contamination, particularly if you share a kitchen with others:

  • Buy separate containers of foods such as peanut butter, jam, mayonnaise, and margarine to avoid any contact with a knife or spoon that has been used on bread.

  • Buy squeeze bottles of condiments.

  • Use separate cutlery and cutting boards for gluten-free foods.

  • Have a separate toaster or one with a removable rack that can be washed.

  • Wipe counter space frequently to get rid of any stray breadcrumbs or flour dust.

  • Don't buy products from bulk bins because the scoops could have been used in bins of gluten-containing products.

  • Be careful at buffets where utensils may be used for a variety of dishes, including those with gluten.

  • When eating out, ask how food is prepared and if arrangements can be made to prevent contamination.

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