Celiac disease is a chronic autoimmune condition that harms the lining of the small intestine. The disease is triggered when a person consumes foods containing gluten, a protein found in wheat, barley, and rye. Although there is no cure, the condition can be effectively managed—primarily through a strict gluten-free diet and supportive care.

Symptoms vary from person to person. Some individuals may experience digestive issues such as constipation, abdominal discomfort, and bloating. Others might deal with fatigue, itchy rashes or blisters, and mood-related concerns such as depression.

If left untreated, celiac disease can lead to serious complications like malnutrition, weakened bones (osteoporosis), and anemia. The primary goal of treatment is to prevent further damage to the small intestine. Healthcare providers often refer patients to dietitians or nutritionists to develop a personalized gluten-free eating plan.

Lifestyle Management

Avoiding Gluten in Foods
The most essential step in managing celiac disease is eliminating gluten from the diet. A strict gluten-free diet can significantly reduce symptoms within a few days or weeks and promote healing in the small intestine.

Foods that commonly contain gluten and may cause flare-ups include:

  • Baked goods such as bread, cookies, and crackers

  • Whole grain products

  • Beers, malt beverages, ales, and some flavored liquors

  • Food additives like thickeners, starches, and colorings

  • Some vitamin and mineral supplements

Gluten is also found in unexpected sources like personal care products. For individuals with strong sensitivities, even using hair products containing gluten can cause symptoms. Gluten may also be found in cosmetics, toothpaste, mouthwash, and modeling clay used by children.

Gluten-Free Foods
Fortunately, many gluten-free alternatives exist. In addition to specialty products like gluten-free bread and pastries, there are also numerous naturally gluten-free foods that can be included in the diet.

These include:

  • Beef

  • Chicken

  • Fish

  • Rice

  • Quinoa

  • Buckwheat

  • Corn

  • Soybeans

  • Potatoes

Cross-contamination can be a major issue. Even with a gluten-free diet, people may unknowingly consume small amounts of gluten if their food comes into contact with gluten-containing items during preparation or cooking.

Since a gluten-free diet may lack certain nutrients like fiber, vitamins, and minerals, it’s important to work with a healthcare provider to ensure proper nutritional balance.

Medications

General Approach
In most cases, medication is not required to treat celiac disease. In fact, some medications may contain gluten and could trigger symptoms such as fatigue, bloating, and digestive discomfort.

Maintaining a gluten-free diet remains the cornerstone of treatment. However, managing celiac disease in a gluten-rich food environment can be challenging. Some people continue to have symptoms despite following a gluten-free diet—a condition known as refractory celiac disease.

Prescription Medications
Some individuals with celiac disease develop dermatitis herpetiformis, a blistering and itchy skin condition caused by gluten exposure. In such cases, healthcare providers may prescribe topical corticosteroids, such as prednisone, to reduce inflammation.

For those with refractory celiac disease, oral corticosteroids like prednisolone or budesonide may be used to minimize intestinal inflammation. While these medications can help manage symptoms, they cannot reverse existing intestinal damage.

Over-the-Counter Treatments
Damage to the small intestine can result in poor nutrient absorption. Over time, this can lead to vitamin and mineral deficiencies. Healthcare providers often use blood tests to assess nutrient levels.

Common deficiencies among individuals with celiac disease include:

  • Vitamin B12

  • Iron

  • Folic acid (vitamin B9)

  • Vitamin D

  • Zinc

Supplementation may be recommended to prevent further deficiencies. It's important to consult a healthcare professional before starting any new supplements.

Surgeries and Procedures

Surgical intervention is rarely required for celiac disease but may be necessary to address severe complications stemming from prolonged malabsorption.

Total Parenteral Nutrition (TPN)
In extreme cases where malnutrition is severe, healthcare providers may recommend TPN. This involves delivering liquid nutrients directly into the bloodstream through an intravenous (IV) line. The speed of recovery depends on the severity of the nutritional deficiency.

Abdominal Surgery
Surgery may be used to correct life-threatening or serious complications caused by intestinal damage. These include:

  • Bowel obstruction: Inflammation may block the intestines, requiring surgical removal of damaged sections.

  • Perforated bowel: Holes in the intestinal wall may need repair using minimally invasive techniques.

  • Intestinal hemorrhage: Surgery may be needed to stop gastrointestinal bleeding.

  • Cancer: Celiac disease can increase the risk of rare cancers like enteropathy-associated T-cell lymphoma. Treatment might involve surgery to remove tumors, followed by chemotherapy.

Prognosis and Life Expectancy

While celiac disease has no known cure, following a gluten-free diet significantly improves symptoms and quality of life. Without proper management, complications such as weakened bones, depression, cancer, and fatigue can arise.

Research shows that untreated celiac disease is linked to higher rates of anxiety and depression. However, individuals who adopt a gluten-free lifestyle often see notable improvements in mood and mental health.

Most people with celiac disease who follow their treatment plan live long, healthy lives. However, ongoing exposure to gluten and lack of treatment can impact long-term health and life expectancy.

Living With Celiac Disease

Living with celiac disease involves long-term adjustments to diet and daily habits. Although there is no cure, proper treatment can reduce or eliminate symptoms like bloating, fatigue, skin irritation, and digestive pain.

Even on a gluten-free diet, small amounts of gluten can be difficult to avoid entirely. To minimize exposure, consider the following:

  • Always check food labels carefully

  • Prepare gluten-free foods separately from other meals

  • Inform restaurant staff of your dietary needs

Coping with a celiac diagnosis can affect mental and emotional well-being. If you're struggling, talk to a healthcare provider about counseling or therapy options.

You can also connect with others through virtual support groups offered by organizations like the National Celiac Association and Beyond Celiac. These communities provide education, shared experiences, and emotional support for people navigating life with celiac disease.