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Those of us who are  very careful know this.  I was surprised at the low percentage of study participants who are "vigilant".

"Current guidelines for managing celiac disease call for “lifelong adherence to a strict, gluten-free diet,” study leader Randi Wolf of Columbia University in New York City told Reuters Health in an email. 

But the ‘extreme vigilance’ required to follow a strict gluten-free diet may also have negative consequences, both physically and emotionally, Wolf said. 


see article at link:
https://www.reuters.com/article/us-health-celiac-stress/vigilant-adherence-to-celiac-diet-linked-with-lower-quality-of-life-idUSKCN1FX30S?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202018-02-14&utm_term=US%20Health%20Report

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