Most people with celiac disease have a significant improvement in symptoms when they follow a gluten-free diet. Health care providers typically refer people to a dietitian who specializes in treating people with the disease. The dietitian will teach the person to avoid gluten while following a healthy and nutritious diet. The dietitian will give the person instructions for how to
                
- read food and product labels and identify ingredients that contain gluten  - make healthy choices about the types of foods to eat  - design everyday meal plans
                
For most people, following a gluten-free diet will stop symptoms, heal existing intestinal damage, and prevent further damage. Symptoms may improve within days to weeks of starting the diet. The small intestine usually heals in 3 to 6 months in children. Complete healing can take several years in adults. Once the intestine heals, the villi will absorb nutrients from food into the bloodstream normally.
                
Some people with celiac disease show no improvement after starting a gluten-free diet. The most common reason for poor response to dietary changes is that people are still consuming small amounts of gluten, which can damage the small intestineeven in people without symptoms. Most people start responding to the gluten-free diet once they find and eliminate hidden sources of gluten from their diet. Hidden sources of gluten include additives made with wheat, such as
                
- modified food starch  - preservatives  - stabilizers
                

                
Did you know that medications and nonfood products may contain gluten?   Medications, supplements, and other products may also contain lecithin, a hidden source of gluten. People with celiac disease should ask a pharmacist about the ingredients in   - prescription and over-the-counter medications   - vitamins and mineral supplements   - herbal and nutritional supplements    Other products can be ingested or transferred from a person's hands to his or her mouth. Reading product labels can help people avoid gluten exposure. If a product's label does not list its ingredients, the manufacturer should provide a list upon request.   Products that can contain gluten include   - lipstick, lip gloss, and lip balm   - cosmetics   - skin and hair products   - toothpaste and mouthwash   - glue on stamps and envelopes   - children's modeling dough, such as Play-Doh
                
Some people who continue to have symptoms even after changing their diet may have other conditions or disorders that are more common in people with celiac disease. These conditions may include
                
- small intestinal bacterial overgrowth, which happens when too many bacteria grow in the small intestine  - pancreatic exocrine insufficiency, in which the pancreas does not produce enough digestive juice  - microscopic colitis, an inflammation of the colon that a health care provider can see only with a microscope  - IBS  - lactose intolerance, a condition in which people have symptoms after consuming milk or milk products  - other food intolerances, which may occur because of continued damage to the intestine
                
In some cases, people continue to have difficulty absorbing nutrients despite following a strict gluten-free diet. People with this condition, known as refractory celiac disease, have severely damaged intestines that cannot heal. Their intestines are not absorbing enough nutrients, so they may need to receive nutrients intravenously. Researchers continue to evaluate medications to treat refractory celiac disease.
                
Depending on a person's age at diagnosis, some complications of celiac disease will not improve, such as short stature and dental enamel defects.
                
For people with dermatitis herpetiformis, skin symptoms generally respond to a gluten-free diet and may recur if a person adds gluten back into his or her diet. Medications such as dapsone can control the rash's symptoms. Dapsone does not treat intestinal symptoms or damage, so people with dermatitis herpetiformis should maintain a gluten-free diet, even if they don't have digestive symptoms. Even when a person follows a gluten-free diet, the skin lesions from dermatitis herpetiformis may take months or even years to fully heal and often recur over the years.