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Having celiac disease means that you will need to follow a gluten-free diet for the rest of your life. Permanently following a strict diet can be difficult, especially if you are not having symptoms. However, intestinal damage occurs when you eat foods with gluten, regardless of whether you notice symptoms. For more information, see:

Eating plan for celiac disease

The following strategies may help you stick to a gluten-free diet:

• Seek guidance from a registered dietitian, other health professionals, and celiac disease support groups on ways to incorporate gluten-free foods. In the beginning, it may be helpful to keep a food diary until you are more familiar with planning meals without gluten.
• Be aware of foods that contain hidden gluten. Read labels of prepared or processed food carefully. For example, "hydrolyzed vegetable protein" may come from wheat and contain gluten.
• When eating out, let your server know you have special dietary needs. The Celiac Sprue Association has a "restaurant card" that lists foods to avoid (see the Web site at www.csaceliacs.org or the Other Places to Get Help section of this topic). Show this card to your server, who can help you select gluten-free foods or direct the kitchen to specially prepare a meal for you.
• Count calories and check your (or your child's) weight weekly to ensure that enough nutrients are being absorbed.
• Eat plenty of fruits and vegetables to avoid constipation. If necessary, use gluten-free commercial fiber preparations, such as those that contain rice bran.

Following a special diet may be especially hard for children and teens, who often don't want to feel different from their friends. The following strategies may help your child or teen to stick to a gluten-free diet:

• Contact your local hospital, dietitian, or health professional for information about support groups in your area. Most people find these groups helpful for discovering ways to help them deal with their condition.
• Consider different ways to help your child follow the gluten-free diet at school. Talk to teachers or school nurses about everyday strategies. Find out what other kids are taking for lunch. For example, if other kids are carrying cold lunches, find ways to pack similar gluten-free cold lunches. If your child prefers a hot lunch, work with the school cafeteria to see whether gluten-free choices are available. The more "normal" the diet can seem, the better the chances that your child will follow it.
• Let your child have some responsibility. With younger children, make a game out of choosing foods that are gluten-free. Allow older children to choose gluten-free foods. Helping your teen follow a gluten-free diet usually includes recognition of his or her increasing need for independence. Although your teen will make his or her own food choices, talk realistically about the consequences of eating foods with gluten.
• Set realistic goals. Understand that food can be a part of socializing and fitting in. Your child may accidentally (or on purpose) eat some foods that contain gluten. If your child experiences symptoms after eating gluten, focus attention on how he or she feels physically. Periodically remind your child about these reactions, especially before going to a social event where foods containing gluten will likely be served, such as a slumber party. Try to plan ahead for these occasions by talking to friends' parents or preparing something gluten-free that the group can eat.

Some people with celiac disease and their family members may benefit from counseling. Consider talking to your health professional about counseling if you need some extra help managing the emotional challenges that can happen with celiac disease. Counseling can also help you learn ways to talk with your children better and help them follow a gluten-free diet.

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