Celiac disease is a chronic autoimmune disease and it is essentially incurable, but there are ways to manage it.
The essential tenet of living with celiac disease is to avoid gluten in your diet. A gluten-free diet, i.e. food and beverage with a gluten content less than 20 parts per million (ppm), heals the villous atrophy in the small intestine, which is otherwise triggered by ingested dietary gluten.
It is also important to address other dietary issues these patients face. They tend to be deficient in caloric and protein intake, as well as being deficient in fiber, iron, calcium, magnesium, zinc, folate, niacin, riboflavin, vitamin B6, B12 and D. Once they are off gluten, their small intestines begin to recover and they are able to properly absorb nutrients again. But it is a good idea to give daily, gluten-free multivitamin.
For adults, a bone density test is recommended at the time of diagnosis to test for osteopenia/osteoporosis. It may also be ordered for children and adolescents who have experienced severe malabsorption or have bone disease symptoms. Based on the results, these patients may require calcium and vitamin D supplements.
Some patients may develop an associated skin condition, called dermatitis herpetiformis, which is treatable with dapsone or sulfapyridine.
These patients with celiac disease need support and guidance from the doctor and dietitian to start their gluten-free lifestyle. It requires some creativity and planning, but it is very much possible to have a healthy and fulfilling lifestyle despite the restriction.
Once the diagnosis is confirmed and the patient is on a fully gluten-free diet, improvements begin within weeks. In some patients, that does not lead to a full recovery of the intestinal lining. And there are significant consequences of noncompliance. Even a small amount of gluten in diet can damage the small intestine. The rate of intestinal recovery or worsening thereof is based on monitoring the antibody levels.
Gluten-free diet can include potato, rice, soy, or bean (whole or flour), meat, fish, rice, fruits, and vegetables and people with celiac disease can eat as much of these foods as they like. With practice, identifying potential sources of gluten becomes easier and compliance improves. A dietitian can help people learn about their new diet. There are support groups that are particularly helpful in adjusting to this new way of life.
The future is promising for these patients. We are going to pills that when taken immediately before a meal can inhibit absorption of small amounts of gluten and prevent the damage it might cause. New drugs will become available that can diminish the inflammatory response to gluten. Therapeutic vaccines may become available that can restore the tolerance to gluten.
All if the above should making living with the diagnosis of celiac disease easier and more manageable. Until then, it takes an effort to adjust to the new restricted lifestyle but that too gets easier with time.