by Julie Snyder Block, MD
Kids who have celiac disease have an autoimmune disorder caused by an intolerance to gluten and are unable to eat many foods they probably consume every day, such as cereal, bread and pizza.
Gluten is the general name for the proteins found in wheat, rye, barley and the other grains derived from them, such as farina, matzo, orzo, graham powder and panko.
In people with celiac disease, the immune system views gluten as an intruder, and the protein damages villi, the finger-like projections in the small intestine responsible for absorbing nutrients from food. When the villi are damaged, the body can’t absorb the nutrients and vitamins it needs to thrive.
There are a wide variety of symptoms associated with celiac disease. An infant may not gain weight and height as expected, while older children may have chronic diarrhea, abdominal pain and bloating, weight loss, fatigue or skin rashes. Children will most commonly have digestive symptoms, including:
- Abdominal bloating and gas
- Chronic diarrhea
- Pale, foul-smelling stool
- Stomach pain
- Nausea and vomiting
The failure to absorb nutrients during critical years of growth and development can lead to other health issues, such as:
- Failure to thrive in infants
- Delayed puberty in teens
- Delayed growth and short stature
- Weight loss
Many kids are diagnosed when they’re between 6 months and 2 years old, which is when most kids first eat foods with gluten.
No one is certain what triggers celiac disease, although it appears to have a genetic component.
Talk to your pediatrician if your child is showing symptoms that you think might indicate celiac disease. There are several blood tests available that screen for the disease, and a small intestinal biopsy is performed to confirm the diagnosis.
Talk to your primary care doctor about getting tested as well, since there is evidence that the condition runs in families. In 50 percent of individuals who have celiac disease, a family member, when screened, also has the disease, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
Celiac disease is treated by not eating gluten, which can be challenging because gluten is in many foods. Gluten is not only present in the grains listed in the prior definition, but also is used as a thickening agent and filler in common products, such as ketchup, ice cream and even some medications.
Besides foods that contain gluten, foods in a kitchen or restaurant can get contaminated by being processed on the same machinery as foods with gluten, or stirred or strained with gluten-touched utensils.
Some individuals don’t test positive for celiac disease, but they still have adverse reactions to gluten. Unlike celiac disease, gluten sensitivity doesn’t damage the intestine, and there are no accepted medical tests for the condition. The most common symptoms of gluten sensitivity are:
- Mental fatigue
- Gas, bloating and abdominal pain
It’s important to talk with your pediatrician before diagnosing your child or beginning a gluten-free diet. The diagnostic tests for celiac disease are dependent on the presence of gluten or wheat in your child’s body in order to work.
This Scripps Health and Wellness information was provided by Julie Snyder Block, pediatrician at Scripps Coastal Medical Clinic Encinitas.