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People with coeliac disease must follow a lifelong gluten-free diet. This usually requires consultation with a dietician and a careful review of food ingredients to be successful. Once all forms of wheat, rye, barley and often oats, have been removed from the diet, autoantibody levels will begin to fall and the intestine will heal. The Australian Coeliac Association states that; “1 in 5 people with coeliac disease have an autoimmune reaction to the avenin in oats. The only way people who react to oats can be confirmed is by biopsy before and after a period eating oats. This is not practical or desirable for many people so the approach often taken in Australia is that oats are not safe for people on a gluten free diet.”
While most if not all of the intestinal damage caused by coeliac disease is reversible, some effects of prolonged malnutrition and malabsorption – such as short stature and weakened bones – may be permanent. It is important to detect and treat coeliac disease as soon as possible, especially in young children. Coeliac disease should be considered in infants who are not thriving, since foods with gluten are common and coeliac autoantibodies may begin to develop shortly after a child switches from milk to solid foods.
In most cases, those on a strict gluten-free diet will remain healthy and symptom-free and can live a relatively normal life. However, if a person begins to consume gluten-containing foods again, within a short period of time both the symptoms of coeliac disease and the damage to intestinal villi will return. Even people with few or no symptoms can have intestinal damage and, over time, may develop complications, such as nutritional deficiencies and decreased bone mineral density. Coeliac disease when uncontrolled is associated with an increased risk of non-Hodgkins lymphoma.
A small percentage of those affected by coeliac disease do not respond to a gluten-free diet and/or may have irreversible damage to the intestine. These people may require additional medical interventions and nutritional support.
Last Review Date: June 4, 2017