Coeliac Disease: Management

Key points

• Management is a lifelong gluten-free diet. Gluten-containing cereals to avoid include:
• wheat (bread, pasta, pastry)
• barley (including beer) and rye; oats are tolerated by most but a minority react to avenin
• Naturally gluten-free foods include corn (maize), rice and potatoes.
• Anti-TTG antibodies can monitor dietary compliance. Coeliac disease causes functional hyposplenism, so give pneumococcal vaccination (booster every 5 years) and annual influenza vaccine; monitor bone health (DEXA) and correct deficiencies (iron, folate, B12, vitamin D).