Treatment of celiac disease and nutrition


What is therapy for celiac disease?

Vitamins and mineral supplements
If there are serious nutritional deficiencies, the doctor or nutritionist may recommend taking supplements with vitamins and mineral salts.

It may be necessary to increase the following levels:

  • Calcium
  • Folic acid
  • Iron
  • Vitamin B12
  • Vitamin D
  • Vitamin k
  • Zinc

Supplements are usually taken in the form of tablets.
If the digestive system has absorption problems with regard to vitamins, the doctor can remedy this by injecting it.

used to treat intestinal inflammation 
If the small intestine is damaged by celiac disease, the doctor may recommend corticosteroids to treat the inflammation. Steroids can relieve serious signs and symptoms of celiac disease while the intestines heal.

Dermatitis herpetiformis
If you suffer from these itchy blister rashes, which sometimes accompany celiac disease, the doctor may recommend a skin medication (dapsone) in conjunction with a gluten-free diet.

New findings on celiac disease treatment
Scientists have been researching a vaccine since 2010 to block the body’s immune response when it absorbs gluten.
To date, no efficacy of the vaccine that is being worked on has been proven.

Gluten-free diet
As soon as celiac disease is diagnosed, one should consult a nutritionist for the preparation of gluten-free food.
The professional can ensure that the diet is balanced and contains all the nutrients that the body needs.
Anyone suffering from celiac disease cannot digest foods containing wheat (flour, semolina, couscous and spelt), barley or rye.
Even if only a small amount is consumed, such as a spoonful of spaghetti, very unpleasant intestinal problems can occur.
If you continue to consume gluten regularly, there will also be an increased risk of colon cancer and osteoporosis in the future.
Gluten is made up of different proteins and is not essential for the diet, so you can replace it with other foods.
There are many gluten-free alternatives in the supermarkets and grocery stores, including pasta, pizza and bread, even if the taste is not the same.
A number of gluten-free foods are available by prescription.

Many staples – such as meat, vegetables, cheese, potatoes and whole grain rice – are naturally gluten-free, so you can include them in your diet.
The dietitian can help identify the safe and the non-recommended foods.

Prohibited foods and ingredients

All food labels must clearly indicate whether the food contains any of the eight food allergens, including wheat. Lawmakers are also pushing for clearer labels for people with celiac disease to identify other components, such as hidden ingredients, barley and rye.

One should know the foods to avoid, such as:

  • beer and other wheat-based alcoholic products,
  • broths and soups,
  • breading (for example, breadcrumbs for chicken cutlets, etc.),
  • wholemeal rice syrup (often barley-based),
  • cake (contains wheat),
  • caramel dye (may be made with barley),
  • Wafers
  • Couscous
  • breaded vegetables or cream,
  • Dextrin (a rare ingredient derived from wheat; Maltodextrins are good for people with gluten intolerance),
  • dried roasted walnuts (wheat flour or flavorings can be used during processing),
  • fried chicken,
  • potato chips (if coated with flour),
  • sauces (including some tomato sauces),
  • crab or other seafood,
  • processed meat,
  • malt or malt flavouring (usually barley-based),
  • modified starch (most food manufacturers now indicate the source of this ingredient; for example, modified corn starch, which is fine, while modified wheat starch is not good),
  • Powdered milk
  • Noodles
  • Salad dressing
  • condiments (if they only contain spices, that’s fine, but you should check them for possible gluten additives),
  • some flavoured coffee blends and herbal teas,
  • soups and canned soups,
  • Soy sauce and solid soy sauce (these can be fermented with cereals; do not consume until you have spoken to the dietician),
  • creams, soft cheeses and soups,
  • Fillings
  • Thickener
  • Noodles (a plate of Japanese noodles, often made from wheat flour, is usually served in broth),
  • Products without wheat (wheat-free does not mean gluten-free; many biscuits and breads without wheat contain barley or rye flour, which contains gluten and other gluten-containing ingredients),
  • yogurt with wheat starch,
  • breakfast dishes (e.g. muesli),
  • Honey and sugar.

You should always check the food labels before buying them. Many foods, especially convenience products, contain gluten as additives, such as malt flavor and modified starch.

Gluten can also be found in non-food products, including lipstick, stamps, and some types of medication.
Contamination can also occur when gluten-free foods and foods containing gluten are prepared together or served with the same cutlery.
Therefore, it is not enough to go to a restaurant and bring gluten-free pasta. The restaurant must also be equipped with two separate kitchens and different waiters.

Gluten-free foods (which you can eat)

Those who suffer from celiac disease can eat the following gluten-free foods:

  • fresh meat, fish and poultry that are not breaded or prepared with dough or marinade,
  • Fruit
  • most dairy products such as cheese, butter and milk,
  • Potatoes
  • Vegetable
  • Spirits, cider, liqueur, wine and water.

Cereal and starchy products that are allowed in a gluten-free diet, such as:

  • Amaranth
  • Buckwheat
  • Corn
  • Cornmeal
  • gluten-free flours (rice, soybeans, corn, potatoes, beans),
  • tortillas of pure maize,
  • Quinoa
  • Brown rice
  • Tapioca.

Fortunately, there are an increasing number of gluten-free products available for lovers of bread and pasta. If one of these products cannot be found in the local bakery or supermarket, you can also order them online. There are many gluten-free substitutes for foods that normally contain gluten.

Under the law, foods labeled “gluten-free” may not contain more than 20 parts per million (ppm) of gluten.
For most people, these traces of gluten do not cause any problems. However, there is a minority of people with celiac disease who cannot tolerate even these few traces and need a completely gluten-free diet.

Oats do not contain gluten, but many people with celiac disease still avoid this food because it can be contaminated with other grains.
If oats are to be included in the diet, it must be ensured that they are not contaminated.
One should initially avoid oats until a gluten-free diet is well established and the symptoms have disappeared.
Once the symptoms have passed, oats can be gradually included in the diet. If symptoms recur, oats should be avoided.

Recommendations for children’s
One should not include gluten in the child’s diet before he or she is six months old. Breast milk is naturally gluten-free, as are all milk preparations for infants.
If the mother suffers from celiac disease, gluten-containing foods should be gradually introduced into the diet when a child is at least six months old and closely monitor the situation.

Eat out

Those who suffer from celiac disease do not have to limit themselves to eating at home. With experience and knowledge, you will be able to understand which dishes in the restaurants or at friends’ homes contain gluten.
There are already some restaurants that offer gluten-free dishes in their menu.
Local support groups may have a list of restaurants where the chef is familiar with the gluten-free diet. You can ask at the restaurant or ask your nutritionist or the celiac support group for this information.
No matter how well prepared, sometimes you can’t figure out if a particular food is gluten-free.

When in doubt, avoid!
Here are some helpful tips when choosing foods for celiac disease:

Start with food you can eat. Foods and ingredients to eat and use in the kitchen: Foods made from flour from corn, whole grain rice, buckwheat, millet, chickpeas, quinoa, tapioca and potatoes (provided that the other ingredients of the recipe do not contain gluten).
You can eat vegetables, fish, chicken, legumes, walnuts, seeds, oil, milk, cheese, eggs, fruit and meat without spices.

Watch out
for possible contamination 
Even if you eat or prepare foods that are gluten-free, there is a risk of cross-contamination if these foods come into contact with other gluten-containing foods.
For example, crumbs of wheat bread can get into a bowl of jam, cream, or dressing if individuals don’t take care to use a clean knife or cutlery every time.
Condiments, creams and jams should each be stored in separate containers. This is very helpful for people who have gluten intolerance.
Likewise, it’s a good idea to use your own toaster for gluten-free bread.
If someone in the family cooks with products that contain gluten, it’s important to clean the vessels, utensils, and countertop well before preparing gluten-free products. One should remember to wash one’s hands well and often.

If the environment in which food is produced is not intended for gluten-free foods, there is a risk of contamination. If, for example, gluten-free bread is prepared in a bakery that also produces normal baked goods, contamination can occur.
This can happen if the machines are not thoroughly cleaned between the production of gluten-containing and gluten-free products. Some bakeries nowadays produce their products in a gluten-free environment.

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