9 Tips to Help Adjust to Life with Celiac Disease

If you’ve just found out you have celiac disease, an autoimmune condition triggered by gluten exposure, adjusting to life without gluten can feel overwhelming.

Gluten is a protein found in wheat, barley and rye. It is present in many foods, including breads, pastas, cereals, crackers and beer.

If you have celiac disease, you’ll need to stop consuming gluten completely to find relief from the condition’s common systems: bloating, diarrhea, gastrointestinal discomfort and gas.

While revamping your diet can be a big adjustment, there are many tools available to help you succeed and still enjoy foods that you love—and likely help you feel better, too.

UNC Health gastroenterologist Zachary Spiritos, MD, MPH, and registered dietitian Natalie Newell share their advice on adjusting to a gluten-free life.

1. Keep a food journal.

Write down the foods you enjoy that are a part of your daily diet. Then you can evaluate which ones have gluten and try to find replacements.

“If you like to eat toast with peanut butter every morning, try to find a gluten-free bread so that you can still enjoy the breakfast you like,” Newell says.

Some swaps will require a homemade recipe (consider making these items in bulk and freezing them to save time), but others are available prepackaged at the grocery store.

“Thankfully, there are a lot more options now than there were 15 years ago,” Newell says. But there is a caveat: Gluten is often used as a binder to help food stick together, so sometimes fat and sugar are added to gluten-free foods to make up for that. In other words, foods labeled “gluten-free” aren’t necessarily healthy—they might just be better for your gut, Newell says.

Keeping a food journal can also help you pinpoint gluten exposure in case you consume some accidently.

2. Meet with a registered dietitian.

A registered dietitian can help you develop a balanced meal plan, understand food labels and recognize foods that have gluten. They can also help you identify swaps and recipes for the foods you love and offer support through difficult times of transition.

3. Beware of cross-contamination.

Even a little bit of gluten can damage your small intestine and make you feel bad. It’s important to understand the dangers of cross-contamination, when a gluten-free item comes in contact with one that is not gluten-free.

Cross-contamination can happen easily—maybe the same knife is used to spread peanut butter on regular bread and then on gluten-free bread, for example.

To combat this, prepare your kitchen accordingly, especially if you are the only one in your household going gluten-free. Make sure you have your own utensils and cooking equipment to avoid cross-contamination, Newell says.

4. Tell your friends and family.

Going gluten-free is a big lifestyle change, and it’s important to clue in your friends and family so they can offer support. Make sure they understand the dangers of cross-contamination and how bad it could make you feel.

It can also help to have extra eyes looking out for gluten-free product swaps and recipes, as well as people who can help you meal prep.

5. Shop the perimeter of the grocery store.

Shopping the outer aisles of the grocery store, where the lean meats and fresh fruits and vegetables are, helps you avoid the processed foods in the middle. That’s a good rule of thumb for anyone looking to maintain a healthy diet, but it’s especially important for people with celiac disease. They’ll need to consume enough fiber to make up for the lack of wheat in their diet.

“You want to shoot for between 25 and 35 grams of fiber per day. Any less than that could leave you feeling constipated,” Newell says.

If you do venture into the processed foods, there are apps that can help you determine whether a product is gluten-free. And Newell recommends making a list before you go to the store to help you stay focused on your meal plan.

6. Look out for hidden gluten.

Sometimes gluten is included in products that you wouldn’t expect, such as soy sauce, meat tenderizers, dressings and seasonings. Energy and protein bars often have gluten, too. Many restaurants put pancake batter in their eggs to make them fluffier.

Items with labels that are compliant with U.S. Food and Drug Administration requirements must specify if they contain wheat, but not barley or rye, so be sure to read the entire label closely.

Gluten can hide in some nonfood products, such as sunscreen, moisturizer, supplements and toothpaste. If you get sick, check the labels of every product you used or consumed to try to find the culprit, Newell says.

7. Don’t avoid parties or social gatherings.

Having celiac disease doesn’t mean you can never enjoy yourself at a party again. It just takes a little planning.

“Some tips for parties include bringing your own food, eating prior to going, and looking for raw items like fruit and veggies—making sure you avoid dip unless you can read the label and confirm there’s no gluten,” Newell says.

It can also help to remember why you’re attending the party in the first place.

“While food is a central part of social gatherings, the primary purpose of a gathering is to connect with others,” Dr. Spiritos says. “Focusing on conversations and activities can help reduce the anxiety around food.”

8. Remember that you’ll probably feel better soon.

As you eliminate gluten from your diet, the inflammation in the small intestines will slowly start to go away.

“Most patients have improvement in their symptoms within a few weeks after removing gluten from their diet,” Dr. Spiritos says. “We start to see healing and complete regeneration of the lining of the small intestines within one to two years of strict adherence to a gluten-free diet.”

9. Be your own advocate.

Going gluten-free will require you to ask more questions about the food you consume. This could mean asking a restaurant server about the seasonings on certain menu items or the potential for cross-contamination, or contacting a company about its ingredient list.

“You want to be forward about this aspect of your health,” Newell says. “It takes a lot of work to eliminate gluten, and you don’t want to feel sick again after you’ve worked so hard.”

It’s also important to remember that you are in control of your health.

“You can do it!” Dr. Spiritos says. “With proper education and support, you can manage your condition effectively without a major impact on your life.”

 Looking for a gastroenterologist or a registered dietitian? Talk to your doctor, or find one near you.