Currently, the only treatment for celiac disease is a strict, lifelong gluten-free diet. Eating gluten, even in very small amounts, can damage the intestine. Learn more about the gluten-free diet here.

However, celiac disease can be a complicated condition, and the gluten-free diet isn’t always easy to manage, so you should continue to get care from your healthcare team even after diagnosis. Below is an overview of what you and your team may want to consider.

Celiac Disease Management

The American Gastroenterological Association and the American College of Gastroenterology recommend regular healthcare follow-up with a physician and dietitian for those with celiac disease. This care is critical to providing patients with accurate information about the gluten-free diet and improving adherence to it.

Managing celiac disease can involve:

• A team approach with skilled physicians and dietitian
• Education about celiac disease and the gluten-free diet
• Identifying credible support and advocacy groups
• Potentially discussing the need for a psychologist who can help with acceptance and coping
• Educating relatives, including asking for their support and for them to be tested
• Regular follow-up care and testing

Pediatric celiac disease management should also focus on monitoring the child’s growth, discussing the need for a 504 plan at the child’s school, and age-specific support groups and/or summer camps.

Laboratory Tests for Celiac Disease Monitoring

Celiac disease damages the small intestine, which absorbs nutrients, vitamins, and minerals from food. Depending on the level of damage, people with celiac disease may be deficient in essential vitamins and nutrients when diagnosed. Laboratory tests can identify deficiencies and risks of developing other conditions.

Regular monitoring with blood tests can also help answer the following questions:

• Am I being exposed to gluten?
• Am I at risk of developing nutritional deficiencies and associated diseases?
• Is my immune system normalizing?

Laboratory tests may include:

• Celiac disease antibodies (IgA-tTG)
• Nutritional anemia profile (hemoglobin, hematocrit, folate, ferritin, vitamin B12)
• Vitamin profile (thiamin, vitamin B6, 25-hydroxy vitamin D)
• Mineral profile (copper, zinc)
• Lipid profile
• Electrolyte and renal profile
• Complete blood count (CBC)
• Thyroid-stimulating hormone (TSH)
• In adults, a bone mineral density scan within the first year of diagnosis.

Laboratory tests should be performed at diagnosis, within three to six months following a diagnosis, and annually for the rest of your life. The specific tests you receive will vary depending on your situation and your doctor’s advice.

While blood tests are extremely helpful, research has shown that the results don’t always detect damage to the intestine. If your blood tests are consistently abnormal, your healthcare team may recommend a follow-up endoscopy to evaluate any change in intestinal damage.

Gluten Exposure Testing

There are stool and urine tests to detect whether gluten has recently been in your system. Some of these are available for at-home use. Learn more about monitoring with at-home urine and stool testing from our research news post.