Celiac Disease
What is celiac disease?
Celiac disease is also known as gluten sensitive enteropathy because it is the presence of gluten in the diet that causes it in certain people. The exact mechanism isn’t known, but we do know that gluten somehow triggers the immune system to cause an inflammatory reaction in the small intestine. It is the second most common cause of children not absorbing food well (the first is cystic fibrosis). The key feature is that in the presence of gluten the small intestine is affected, and when gluten is taken from the diet, the intestine improves.
What are the symptoms of celiac disease?
The symptoms of celiac disease can vary widely, from none to completely malnourished. Often, those with symptoms will start between one and two years old (when gluten containing foods are usually introduced), and can include diarrhea, throwing up, and signs of deficiencies of different nutrients. Deficiencies can occur because an irritated, inflamed intestine may not be able to absorb things like iron, vitamin D, calcium, and folate.
How is celiac disease diagnosed?
Often it is diagnosed by checking the antibodies of family members of someone already diagnosed with celiac disease. Because the incidence in close family members is increased, they are often checked as well.
Since the symptoms can vary so much, usually diagnosis starts with general labs like stool studies, chemistry, or white count to get a better idea of what’s happening with the child. When celiac disease is suspected, the specific antibodies can be checked. Usually a referral to a gastroenterology specialist is next. They will make the final diagnosis by checking the small intestine using a scope before and after a gluten free diet.
Who gets celiac disease?
Two things are required to develop celiac disease; the ‘correct’ genes must be present, and the child has to be exposed to gluten. Some of these people have the genes and the right antibodies, but have nothing wrong with their small intestine and no outward signs of the disease. There are others that have the genes and antibodies, have inflammation in their small intestine, but have no outward signs of the disease.
How is celiac disease treated?
The main treatment for celiac disease is a gluten free diet. With the choices, recipe books, and support groups available today it is easier than it used to be, but still is quite a difficult diet. With these children even a tiny amount of gluten can cause the inflammation to worsen. Rarely, a gluten free diet alone doesn’t help, so an immune modulator will be added. Supplements as needed for any deficiencies will also be added to the treatment.
Bottom line.
Celiac disease can be a serious disease in children. Proper diagnosis and treatment can help these children live more normal, healthy lives.
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