The best treatment option for coeliac disease is a strict gluten-free diet.
Gluten Exclusion
In addition to prescribing a gluten-free diet, your doctor will want you to avoid all hidden sources of gluten. If you have celiac disease, ask a pharmacist about ingredients in:
- herbal and nutritional supplements
- prescription and over-the-counter medicines
- vitamin and mineral supplements
Medicines are rare sources of gluten. Even if gluten is present in a medicine, it is likely to be in such small quantities that it would not cause any symptoms. However, even trace amounts of gluten in your diet can be damaging so avoid it.
Removing gluten from your diet will gradually reduce inflammation in your small intestine, causing you to feel better and eventually heal. Children tend to heal more quickly than adults.
Vitamin and mineral supplements
If your anemia or nutritional deficiencies are severe, your doctor or dietitian might recommend that you take supplements, including:
- Copper
- Folate
- Iron
- Vitamin B-12
- Vitamin D
- Vitamin K
- Zinc
Vitamins and supplements are usually taken in pill form. If your digestive tract has trouble absorbing vitamins, your doctor might give them by injection.
Follow-up care
Medical follow-up at regular intervals can ensure that your symptoms have responded to a gluten-free diet. Your doctor will monitor your response with blood tests.
For most people with celiac disease, a gluten-free diet will allow the small intestine to heal. For children, that usually takes three to six months. For adults, complete healing might take several years. If you continue to have symptoms or if symptoms recur, you might need an endoscopy with biopsies to determine whether your intestine has healed.
Medications to control intestinal inflammation
If your small intestine is severely damaged or you have refractory celiac disease, your doctor might recommend steroids to control inflammation. Steroids can ease severe signs and symptoms of celiac disease while the intestine heals. Other drugs, such as azathioprine (Azasan, Imuran) or budesonide (Entocort EC, Uceris), might be used.
Treating dermatitis herpetiformis
If you have this skin rash, your doctor might recommend a medication such as dapsone, taken by mouth, as well as a gluten-free diet. If you take dapsone, you’ll need regular blood tests to check for side effects.
Refractory celiac disease
If you have refractory celiac disease, your small intestine won’t heal. Then you’ll likely need to be evaluated in a specialized center. Refractory celiac disease can be quite serious, and there is currently no proven treatment.
It’s also important to be aware that, while a gluten-free diet can be effective in managing the symptoms of coeliac disease, it’s not always enough to fully heal the damage that has been done to the small intestine, so people with coeliac disease should work closely with their healthcare provider to monitor their symptoms, complications, and overall health.