Celiac Disease Treatment

The goals of treatment for celiac disease are to prevent damage to the small intestine and avoid complications. Patients who have the disorder must follow a life-long diet that is free of gluten. This is the only treatment for celiac disease at this time.

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. As of August 2014, all food labels must be in compliance with this regulation.

In addition to containing less that 20 ppm of gluten, foods that contain the labels above (e.g., gluten-free, no gluten, etc.) must not contain:

  • an ingredient that is any type of wheat, rye, or barley, or a crossbreed of these grains
  • an ingredient derived from wheat, rye, barley, or crossbreeds that has not been processed to remove gluten
  • an ingredient derived from wheat, rye, barley, or crossbreeds that although processed to remove gluten, contains more than 20 parts per million gluten

Foods to Avoid

The most obvious foods to avoid include breads, breakfast cereals, pasta, crackers, cookies, cakes, and pies. Fortunately, many gluten-free products are now being produced as substitutes for these favorites.

Gluten is found in the following types of grains:

  • Barley (including malt, malt flavoring, and malt vinegar)
  • Einkorn
  • Emmer
  • Kamut
  • Rye
  • Spelt
  • Triticale
  • Wheat (including bulgur, couscous, duram, farina, semolina)

Although oats do not contain gluten, they are often stored in the same facilities as wheat and other grains that do contain gluten. Because of this, some oats may contain traces of gluten. Oats that are free of gluten contamination are now available and are clearly labeled as such.

Gluten may also be "hidden" in certain foods, including the following:

  • Additives (e.g., modified food starch, hydrolyzed vegetable protein)
  • Beer
  • Bouillon
  • Brown rice syrup
  • Candy, licorice
  • Canned soups, gravies, and sauces (e.g., salad dressing, marinade)
  • Deli meats, sausages, hot dogs, seafood salads, and imitation crabmeat
  • French fries, other battered and deep fried foods
  • Graham crackers
  • Matzo and communion wafers
  • Rice mixes
  • Seasoning mixes
  • Self-basting turkeys
  • Snack chips (including potato chips and seasoned tortilla chips)
  • Soy sauce
  • Vitamins and medicines

Processed foods that do not have gluten listed in the ingredients may contain enough gluten to cause an immune response, especially if they were manufactured with equipment used to make other products that contain gluten.

In addition to reading ingredients lists, it is important to search for the term "gluten-free" on food labels. Gluten-free foods should be kept in a special area of the kitchen or pantry—even a small amount of dust from wheat flour settling on gluten-free foods could trigger an immune reaction.

Naturally Gluten-Free Foods

Many foods do not contain gluten. According to the National Institutes of Health (NIH), the following foods are naturally gluten free:

  • Beans
  • Dairy foods
  • Eggs
  • Fish
  • Fruits
  • Meat
  • Nuts
  • Poultry
  • Seeds
  • Vegetables

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 28 Feb 2008

Last Modified: 17 Aug 2015