The Gluten-Free Diet: A Practical Look

Celiac disease is a global disease, and currently the only available treatment is a gluten-free diet. In the developed world there are a lot of resources for people with celiac disease who need to be on a gluten-free diet, but it is still a substantial challenge. As celiac disease is being diagnosed in other countries, social, financial, cultural differences come into play, and can impact the ability of the celiac patient to follow a gluten-free diet. Dr. Joseph Murray, M. D., co-author of a recent paper published in Nature Reviews, Gastroenetrology and Hepatology, reviews some of these challenges and suggests strategies to maximize successful treatment, achieve healing, and prevent complications.

Some important highlights from the article:

• The goals of treatment are best achieved when patients are managed by a team approach, including expert physicians and dietitians and community support.
• The grains to be avoided on a gluten-free diet are wheat, barley and rye.
• Patients with celiac disease must become expert label readers, and, because product ingredients change, must re-check labels at each purchase.
• Worldwide, the availability of gluten-free foods is limited, especially in less-developed areas. Patients with celiac disease might access standard gluten-free foods by prescription and, in developed countries, many supermarkets now provide gluten-free sections.
• The requirement for a strict gluten-free diet often affects social interactions. The burgeoning interest in gluten-free foods has led restaurants to offer gluten-free options on their menus. Many travel websites and mobile apps identify gluten-friendly restaurants, hotels, cruises and grocers near one's travel destination.
• Once the diagnosis of celiac disease has been made, patients should be taught about the gluten-free diet with appropriate follow-up according to the individual's needs until a good understanding is achieved.
• Dietary adherence is essential to achieve small bowel mucosal healing and alleviation of gastrointestinal symptoms.

Dr. Murray concludes that, "Central to success is engagement of the public health system, of doctors and dietitians who can support celiac patients in achieving wellness through a gluten-free diet."

Read the full journal review online here.

For more information about celiac disease, visit mayoclinic.org/celiac disease.

Dr. Murray is a gastroenterologist and celiac disease expert at Mayo Clinic.