How is it treated and managed?
The only current treatment of coeliac disease is avoidance of gluten. The treatment is called a gluten free diet. The consequences of eating gluten may be abdominal pain and diarrhoea or recurrence of other symptoms or no symptoms at all; often it will depend on whether there were symptoms to start with. The symptoms are not life threatening but may be unpleasant. Children who are diagnosed on screening and have an abnormal biopsy but who do not have symptoms on eating gluten, may find it more difficult to follow the diet. The consequences of continuing to eat gluten in this circumstance are not known but are thought to be the same as for any child with an abnormal biopsy.
What is a gluten free diet?
A gluten free diet is essentially a diet free from wheat, barley and rye, all of which are frequently included in processed foods. This means that durum wheat, semolina, barley and rye cannot be eaten. Typically the following cannot be eaten because they contain gluten -:
- Bread
- Pasta
- Cereals
- Biscuits and crackers
- Cakes and pastries
- Pies
- Gravies and sauces
- Oats (some people with coeliac will have to avoid oats in addition to wheat)
Gluten free versions of the above foods are available. They can be expensive and so foods and gluten free flour for home baking may be provided on prescription.
The following foods are naturally gluten free and can be eaten freely -:
- Milk, cheese and butter
- Fruit
- Vegetables
- Meat and fish (not breaded or marinated)
- Potatoes
- Rice
- Gluten free flours and grains including rice flour, corn flour, potato flour
Other treatments
Vitamin supplementation may be needed for the first few months to make up for deficiencies that developed before diagnosis. Examples of vitamins and mineral supplements include -:
- Calcium
- Iron
- Folate
Treatment for dermatitis herpetiformis (a skin manifestation of coeliac disease)
Drug treatment in the form of dapsone tablets taken twice daily may be prescribed for this condition. It does resolve on a gluten free diet but dapsone treatment helps to speed up the process.
