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Celiac disease - nutritional considerations

Gluten sensitive enteropathy - diet; Celiac sprue - diet

Celiac disease is an immune disorder passed down through families.

Gluten is a protein found in wheat, barley, rye, or sometimes oats. It may also be found in some medicines. When a person with celiac disease eats or drinks anything containing gluten, the immune system responds by damaging the lining of the small intestine. This affects the body's ability to absorb nutrients.

Carefully following a gluten-free diet helps prevent symptoms of the disease.

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Celiac sprue - foods to avoid

Food Sources

To follow a gluten-free diet means, you need to avoid all foods, drinks, and medicines made with gluten. This means not eating anything made with barley, rye, and wheat. All items made with all-purpose, white, or wheat flour are prohibited.

FOODS YOU CAN EAT

Obvious sources of gluten include:

Less obvious foods that must be eliminated include:

There is a risk for cross-contamination. Items that are naturally gluten-free may become contaminated if they are made on the same production line, or moved together in the same place, as foods containing gluten.

Eating at restaurants, work, school, and social gatherings can be challenging. Call ahead and plan. Due to the widespread use of wheat and barley in foods, it is important to read labels before buying food or eating.

Despite its challenges, maintaining a healthy, balanced diet is possible with education and planning.

Recommendations

Talk to a registered dietitian who specializes in celiac disease and the gluten-free diet to help you plan your diet.

You may also want to join a local support group. These groups can help people with celiac disease share practical advice on ingredients, baking, and ways to cope with this life-altering, lifelong disease.

Your health care provider might suggest you take a multivitamin and mineral or an individual nutrient supplement to correct or prevent a deficiency.

Related Information

Celiac disease – sprue

References

Lebwohi B, Green PHR. Celiac disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 107.

Rubio-Tapia A, Hill ID, Kelly CP, Calderwood AH, Murray JA; American College of Gastroenterology. ACG clinical guidelines: diagnosis and management of celiac disease. Am J Gastroenterol. 2013;108(5):656-677. PMID: 23609613 pubmed.ncbi.nlm.nih.gov/23609613/.

Shand AG, Wilding JPH. Nutritional factors in disease. In: Ralston SH, Penman ID, Strachan MWJ, Hobson RP, eds. Davidson's Principles and Practice of Medicine. 23rd ed. Philadelphia, PA: Elsevier; 2018:chap 19.

Troncone R, Auricchio R. Celiac disease. In: Wyllie R, Hyams JS, Kay M, eds. Pediatric Gastrointestinal and Liver Disease. 6th ed. Philadelphia, PA: Elsevier; 2021:chap 34.

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Review Date: 10/27/2021  

Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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