Gluten-free Diet

No medication or surgical procedure can cure celiac disease. The only way to treat it is to adopt a completely gluten-free diet: avoiding all food and drink containing wheat, barley, rye, and other grains. You must also look out for hidden sources of gluten, like medications, lipstick, communion wafers, and even postage stamps.

A gluten-free diet can be difficult to follow, since gluten is naturally present in many foods and is added to other products such as ice cream and salad dressings. Moreover, some labels do not indicate that a product contains gluten. Thus, you will need to ask about ingredients at restaurants, learn to substitute gluten-free ingredients in recipes, and make sure your foods don't become cross-contaminated with gluten from other foods (for example, from knives, toasters, or cutting boards).

A registered dietitian can help you recognize what foods you can and cannot eat, and the Celiac Sprue Association/USA sells publications that list gluten-free foods and medicines. Joining a support group for people with celiac disease also can be helpful.

In August 2013, the U.S. Food and Drug Administration (FDA) published a new standard definition for the term "gluten-free" on food labels. In order to be labeled, "gluten-free," or use the terms, "no gluten," "free of gluten," or "without gluten," a food must contain less than 20 parts of gluten per million. Manufacturers have one year from the publication of this regulation to bring all food labels in compliance. According to the FDA, may foods labeled as gluten-free already meet the new requirement.

A gluten-free diet eliminates symptoms and reverses damage to the small intestine in most people with celiac disease. Symptoms usually improve within a few days of eliminating gluten, although complete recovery may take anywhere from a few months to several years. To remain symptom free and avoid further damage to the small intestine, you must follow a gluten-free diet for life.

People who do not improve on a gluten-free diet usually have severe damage to the small intestine. In these individuals, medications such as the aminosalicylate anti-inflammatory compound mesalamine (Asacol, Pentasa) or the corticosteroid prednisone may control inflammation in the small intestine and any problems from poor absorption of nutrients.

Publication Review By: H. Franklin Herlong, M.D.; the Editorial Staff at

Published: 28 Mar 2011

Last Modified: 08 Aug 2013