People with celiac disease must follow a lifelong gluten-free diet. This usually requires consultation with a dietitian and a careful review of food ingredients to be successful. Once all forms of wheat, rye, and barley have been removed from the diet, autoantibody levels will begin to fall and the intestine will heal.
While most if not all of the intestinal damage caused by celiac 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 celiac disease as soon as possible, especially in young children. Celiac disease should be considered in infants who are not thriving, since foods with gluten are common and celiac 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 celiac 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.
A small percentage of those affected by celiac 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.