Living Well After a Coeliac Disease Diagnosis

Once you have been diagnosed with coeliac disease, there are things you can do to help alleviate your symptoms and live a healthy, normal life.

Adopting a gluten-free diet

The only treatment for coeliac disease is a strict gluten-free diet.1,2 This is because eating gluten can damage the lining of your intestines.3 Find out more about the effect of gluten on the intestines >

Close-up of person holding slice of fresh whole wheat bread. Male showing tasty rye. Bakery and handmade. Macro shot of component for sandwich. Dieting and nutrition concept

Why should I adopt a gluten-free diet?

Maintaining a strict gluten-free diet is important to resolve symptoms and can also reduce the risk of other health conditions:
 

Bone disease

People with coeliac disease have a higher chance of developing a bone disease (called osteoporosis) and bone fractures than patients without. During the first year of a gluten-free diet your bones will likely get stronger, meaning the risk of having bone issues is lowered.2

Skin problems (dermatitis herpetiformis)

People with coeliac disease may develop dermatitis herpetiformis, which is an intensely itchy, blistering rash on the scalp, shoulders, buttocks, elbows and knees. About 13 in every 100 people with celiac disease also have dermatitis herpetiformis. Dermatitis herpetiformis can usually be controlled by following a gluten-free diet.4

Autoimmune disorders linked to coeliac disease

Coeliac disease is an autoimmune condition, which is when the immune system accidentally harms your own body.5 People with coeliac disease have an increased risk of developing other autoimmune conditions, particularly if they have a family history of them, or if they were diagnosed with coeliac disease at a young age.5 This is known as polyautoimmunity. Up to 15 in 100 people with coeliac disease have another autoimmune condition.5

Following a gluten-free diet is important as it can help you reduce this risk.5

Spleen problems (hyposplenism)

About 30% of adults with coeliac disease develop a problem with their spleen, meaning it doesn’t work as well as it should (known as hyposplenism).6 This risk can be reduced by following a strict gluten-free diet. 

Cancer

Not following a gluten-free diet over a long period of time has been associated with an increased risk of developing certain types of cancer. Following a strict gluten-free diet can reduce the risk of developing cancer in the colon, mouth and throat (oropharyngeal cancer) and small intestine.9

How long will it take to feel better?

Some people may feel better within days of cutting out gluten, but it may take longer for others. This is because the gut damage caused by eating gluten can take 6 months or longer to heal.10,11 If your symptoms increase or you are worried about the gluten-free diet, speak to a healthcare professional. 

What happens if I eat gluten by accident?

Typically, symptoms will start within a few hours after eating gluten. Symptoms can last from hours to days.12

Following a gluten-free diet has been shown to improve the physical and mental health of people with coeliac disease13

What can I do to stay healthy?

Regular check-ups

To ensure that you keep on top of your gluten-free diet and receive the appropriate support, it is recommended that you have regular check-ups with a healthcare professional.2

Your healthcare professional will let you know how often you need check-ups, and it is really important that you attend them. Regular check-ups allow you to be properly supported and updated with any changes in the management of your condition.2 Yearly follow-up appointments may be with a GP, gastroenterologist (doctors specialising in digestive system problems) or specialist nurse or dietitian.14

During each annual appointment:2

Your weight and height will be measured

Your symptoms will be reviewed

Your diet will be evaluated

You will have a blood test that can show if gluten is present in your diet

If any concerns are raised during these appointments, you may need to see a specialist doctor for further checks. This may include further blood tests or bone scans.2

Children should be seen 6-12 months after a diagnosis of coeliac disease, and yearly after that. They will have their height and weight measured to check growth and development.15

Consult a dietitian

Your doctor should refer you to a dietitian who specialises in gluten-free diets.2,8 A dietitian can:

Assess 
how good your diet is

Support
you on how to maintain a healthy gluten-free diet

Help you change 
your diet to meet your needs

Answer 
any questions you may have about your diet or food

Join a support group or organisation

There are coeliac disease societies and support groups which you can reach out to for help with living without gluten. They also provide helpful information and free resources for people with coeliac disease.

The main coeliac disease charity and support group in the UK is Coeliac UK >

Maintaining a gluten-free diet, attending regular check-up appointments and joining a support group are great ways to ensure you stay symptom free.

Speak to your healthcare team for further medical advice.

  1. Leffler D A, Edwards-George J et al. Factors that influence adherence to a gluten-free diet in adults with celiac disease. Dig Dis Sci 2008;53:1573-1581
  2. Al-Toma A, Volta U et al. European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European Gastroenterol J 2019;7:583-613
  3. Dewar D H, Ciclitira P J. Clinical features and diagnosis of celiac disease. Gastroenterology 2005;128:S19-24
  4. Salmi T T. Dermatitis herpetiformis. Clin Exp Dermatol 2019;44:728-731
  5. Lauret E, Rodrigo L. Celiac disease and autoimmune-associated conditions. Biomed Res Int 2013;2013:127589
  6. UK Health Security Agency. Chapter 7: Immunisation of individuals with underlying medical conditions. Green Book, 2020. Available at: https://www.gov.uk/government/publications/immunisation-of-individuals-with-underlying-medical-conditions-the-green-book-chapter-7. Accessed January 2025
  7. Bonanni P, Grazzini M et al. Recommended vaccinations for asplenic and hyposplenic adult patients. Hum Vaccin Immunother 2017;13:359-368
  8. Rubio-Tapia A, Hill I D et al. American College of Gastroenterology guidelines update: diagnosis and management of celiac disease. Am J Gastroenterol 2023;118:59-76
  9. Kalra N, Mukerjee A et al. Current updates on the association between celiac disease and cancer, and the effects of the gluten‑free diet for modifying the risk (review). Int J Funct Nutr 2022;3:2
  10. Cummins A G, Alexander B G et al. Morphometric evaluation of duodenal biopsies in celiac disease. Am J Gastroenterol 2011;106:145-150
  11. Lebwohl B, Granath F et al. Mucosal healing and mortality in coeliac disease. Aliment Pharmacol Ther 2013;37:332-339
  12. Silvester J A, Graff L A et al. Symptomatic suspected gluten exposure is common among patients with coeliac disease on a gluten-free diet. Aliment Pharmacol Ther 2016;44:612-619
  13. Deepak C, Berry N et al. Quality of life in celiac disease and the effect of gluten-free diet. JGH Open 2018;2:124-128
  14. Mulder C J J, Elli L et al. Follow-up of celiac disease in adults: "when, what, who, and where". Nutrients 2023;15
  15. Mearin M L, Agardh D et al. ESPGHAN position paper on management and follow-up of children and adolescents with celiac disease. J Pediatr Gastroenterol Nutr 2022;75:369-386