First-line therapy A strict gluten-free diet must be followed, and usually, this treatment will be a lifelong requirement. Avoidance of gluten will reduce any associated intestinal damage and the risk of other complications. It can be very difficult to maintain a strict gluten-free diet, however, as contamination with gluten is common in many supposedly gluten-free foods and restaurants. Dapsone is an effective initial treatment in most people and is the initial drug of choice to alleviate the rash and itching. Itching is typically reduced within 2–3 days, however, dapsone treatment has no effect on any intestinal damage that might be present. After some time on a gluten-free diet, the dosage of dapsone usually may be reduced or even stopped, although this may take many years. Dapsone is an antibacterial, and its role in the treatment of DH, which is not caused by bacteria, is poorly understood. It may cause adverse effects, especially hemolytic anemia, so regular blood monitoring is required. Alternative treatment options For individuals with DH unable to tolerate dapsone for any reason, alternative treatment options may include the following: * colchicine * lymecycline * nicotinamide * tetracycline * sulfamethoxypyridazine * sulfapyridine Combination therapy with nicotinamide and tetracyclines has been shown to be effective and well tolerated in some individuals who cannot tolerate dapsone or live in places where dapsone is not readily available. While the mechanism of action of tetracyclines and nicotinamide in DH is unknown, it is speculated to be due to their immune-modulating effects. Topical steroid medications are also sometimes used in combination with dapsone and a gluten-free diet to alleviate the itchiness associated with the rash.
symptom of Coeliac disease
symptoms of Helicobacter pylori
symptom of Tropical sprue
symptoms of Crohn's disease
symptom of Irritable bowel syndrome
symptom of Stomach cancer
symptom of Helicobacter pylori
symptom of Gastroesophageal reflux disease