How is the condition treated?
The gluten free diet is the cornerstone of the management of coeliac disease.
The gluten-free diet prevents further damage to the intestinal villi, and allows the intestinal mucosa to return to normal so that nutrients can be properly absorbed.
Grains containing gluten - a rubbery and elastic protein - are used as ingredients in bread, cakes, pasta and many types of prepared and commercial foods.
Although the gluten free diet is not difficult to manage, expert assistance and advice are needed initially. Any person beginning a gluten free diet is strongly advised to do so only under the guidance of a qualified dietitian who can give assistance with advice to suit your individual needs. There are many obvious foods which contain gluten but there are also a whole range of ingredients which can be sources of undisclosed gluten. Learning skills to read and interpret food labels to decide which foods and food ingredients contain gluten is an important part of successfully managing the gluten free diet.
It is the food standard that determines the level of gluten permitted to remain in foods labeled as gluten-free. The Australia New Zealand Food Authority (ANZFA) adopted a new standard in 1995 which does not allow a food product to be labeled as "gluten-free" if it contains detectable gluten.
This differs from the gluten-free food labeling standards in a number of other countries, including the United Kingdom, where the small amounts of gluten found in wheatstarch and malt are permitted in the gluten-free foods sold there. There is now some published data showing that while a proportion of people with coeliac disease are symptomatic when eating wheatstarch and/or malt, a number are not. To date it is unclear if these ingredients have any significant effect of the small bowel mucosa.
These issues are important to note, as quality of life may not improve markedly for all patients. It should be stressed that there are usually no ongoing medications required - treatment is by the gluten-free diet alone. With education, support and practical advice from dietitians, the Coeliac Society and medical practitioners many of these issues can be overcome or managed satisfactorily.
Although the diet can be overwhelming at first, with support, the patient should feel improvements in overall health and well being.