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Treatments and drugs

By Mayo Clinic staff

Digestive Health

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A gluten-free diet is essential, and the only treatment for managing celiac disease. In addition to wheat, foods that contain gluten include:

  • Barley
  • Bulgur
  • Durum
  • Farina
  • Graham flour
  • Malt
  • Rye
  • Semolina
  • Spelt (a form of wheat)
  • Triticale

Your doctor may refer you to a dietitian, who can help you plan a healthy gluten-free diet.

Once gluten is removed from the diet, inflammation in the small intestine generally begins to lessen — usually within several weeks, though you may start to feel better in just a few days. Complete healing and regrowth of the villi may take several months to several years. Healing in the small intestine tends to occur more quickly in children than adults.

If you accidentally eat a product that contains gluten, you may experience abdominal pain and diarrhea. Some people experience no signs or symptoms after eating gluten, but this doesn't mean it's not harmful. Even trace amounts of gluten in your diet can be damaging, whether or not they cause signs or symptoms.

Vitamin and mineral supplements
If your nutritional deficiencies are severe, your doctor or dietitian may recommend taking vitamin and mineral supplements. You may need to supplement your levels of:

  • Calcium
  • Folate
  • Iron
  • Vitamin B-12
  • Vitamin D
  • Vitamin K
  • Zinc

Vitamin supplements are usually taken in pill form. If your digestive tract has trouble absorbing vitamins, your doctor may give them by injection.

Medications to control intestinal inflammation
If your small intestine is severely damaged, your doctor may recommend steroids to control inflammation. Steroids can ease severe signs and symptoms of celiac disease while the intestine heals.

Dermatitis herpetiformis
If you have this itchy, blistering skin rash that sometimes accompanies celiac disease, your doctor may recommend a skin medication (dapsone) along with the gluten-free diet.

Lifestyle and home remedies Tests and diagnosis
References
  1. Ludvigsson JF, et al. The Oslo definitions for coeliac disease and related terms. Gut. 2013;62:43.
  2. AskMayoExpert. What are the most common manifestations of celiac disease today? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
  3. Celiac disease. National Digestive Diseases Information Clearinghouse. http://digestive.niddk.nih.gov/ddiseases/pubs/indigestion/index.aspx. Accessed March 20, 2013.
  4. Scanlon SA, et al. Update on celiac disease — etiology, differential diagnosis, drug targets, and management advances. Clinical and Experimental Gastroenterology. 2011;4:297.
  5. Rashtak S, et al. Review article: Coeliac disease, new approaches to therapy. Alimentary Pharmacology & Therapeutics. 2012;35:768.
  6. Rubio-Tapia A, et al. The prevalence of celiac disease in the United States. American Journal of Gastroenterology. 2012;107:1538.
  7. Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed March 21, 2013.
  8. Rubio-Tapia, A, et al. Prevalence of small intestine bacterial overgrowth diagnosed by quantitative culture of intestinal aspirate in celiac disease. Journal of Clinical Gastroenterology. 2009;43:157.
  9. Rubio-Tapia A, et al. Classification and management of refractory coeliac disease. Gut. 2010;59:547. Accessed March 29, 2013.
  10. Walker MM, et al. An update in the diagnosis of coeliac disease. Histopathology. 2011;59:166.
  11. Rubio-Tapia A, et al. Increased prevalence and mortality in undiagnosed celiac disease. Gastroenterology. 2009;137:88.
  12. Presutti, RJ. Celiac disease. American Family Physician. 2007;76:1795.
DS00319 May 22, 2013

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