Adherence

Strict adherence to a gluten-free diet is the primary determinant of intestinal mucosal recovery in adults with celiac disease, with non-adherence being the main cause of persistent intestinal damage.

For adults with celiac disease, the single most important factor for healing the gut is strict, lifelong avoidance of gluten. While blood tests (EMA) are good at detecting active damage, they are poor at ruling it out. The most reliable, non-invasive way to ensure your gut is healing is to maintain strict dietary compliance, verified by trained interviews, rather than relying solely on serology or feeling asymptomatic.