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WHAT IS COELIAC DISEASE?

 

Sufferers of coeliac disease react badly to gluten, a protein found in wheat, rye, barley and oats. This causes damage to the lining of the small intestine and stops it from working properly. Not only does this cause pain, bloating and diarrhoea, but it stops the absorption of certain important nutrients, which may slow your child's growth.

 

How could my child get it?

 

The exact cause of coeliac disease is not yet known, but there is a 10 per cent chance that, if a parent or other family members have it, so will the child.

 

The incidence of coeliac disease in infancy and childhood is much lower than it used to be. This may be because mothers are encouraged to delay weaning for longer and also because gluten containing foods are not now recommended for babies under six months. However, although there is less overt coeliac disease in childhood children who are genetically predisposed to gluten sensitivity may develop coeliac disease at a later stage in life when exposed to gluten.

 

Symptoms

 

In babies:

·        Diarrhoea

·        Constipation

·        Swollen tummy

·        Failure to gain weight

·        Loss of appetite and vomiting

·        Thin, floppy muscles

In childhood:

·        Diarrhoea or constipation

·        Anaemia

·        Short stature

·        Irritability and fatigue

 

What problems does it cause?

 

The condition makes itself known in. children between. nine months arid three, years of age after the introduction of cereals in the diet; In the short term nutritional deficiencies cause a number of problems:

 

Anaemia: blood needs iron and folic acid to have its normal red pigment –neither are properly absorbed, leading to fatigue and listlessness

 

Low levels of fat soluble vitamins: vitamins A, D, E and K are lost through diarrhoea. Vitamin D is needed for the absorption of calcium, vitamin E for nerve development and vitamin K for normal blood clotting. Lack of Calcium:  This cause a thinning of the bones, called osteoporosis in adulthood.

 

Lack of calories: diarrhoea, vomiting and poor absorption of nutrients lead to weight loss, or a failure to gain weight.

 

Note: there is also an increased risk of other auto-immune diseases, including type 1 diabetes and thyroid problems.

Testing for coeliac disease

 

Many parents are tempted to treat their children themselves by removing gluten from the diet without waiting for medical investigations. The problem with this is that the tests for coeliac disease may then be negative because the children have been on a gluten-free diet; it is better to go to see your doctor first if you suspect that your child may have coeliac disease. Tests include:

 

Biopsy: a tiny piece of the lining of the small intestine is cut away using a tube (introduced through the mouth) called an endoscope. Under a microscope, the normal lining of the small intestine looks like a deep-pile carpet, with lots of hair-like protrusions, called villi, on the surface. With coeliac disease, the villi start to flatten out and the lining looks more like kitchen lino than carpet. The biopsy should be repeated after some time on a gluten-free diet, and again after a gluten challenge to be absolutely certain of coeliac disease.

 

Blood tests: there are two tests that have a high chance of showing a gluten allergy:

The endomysial antibody test and The antigliadin antibody test. Although the blood tests are very accurate, they are not foolproof; specialists prefer to biopsy the gut to confirm the diagnosis.

 

Changing your child’s diet

 

It is difficult to know which foods contain gluten, and the advice of a trained dietitian is invaluable. Here is a guide to the foods to avoid and to what is acceptable on a gluten-free diet:

 

Foods to avoid:

·        Any flour made from wheat, oat, barley or rye

·        Breakfast cereals

·        Bread, cakes, pastries, biscuits, and puddings

·        Most commercially available soups and sauces

·        Semolina

·        Oats - many brands also contain gluten

·        Pasta, macaroni and spaghetti

·        Couscous - this contains semolina

·        Stock cubes

·        Baking powder

·        Soy sauce

·        Suet

 

Food that are allowed:

·        Special gluten-free variations of rice cakes, bread, biscuits, spaghetti and flour can be prescribed by the family doctor

·        Unprocessed meat

·        Vegetable and fruits

·        fish

·        Rice

·        Eggs

·        Potatoes

·        Millet, corn and buckwheat

·        Sago and tapioca

·        Plain Cheese

 

Controlling coeliac disease

 

Controlling the symptoms is the lifelong aim for the coeliac sufferer. On the plus side, avoiding gluten in food will almost always heal the damaged intestine, and there is usually no need for any other treatment. If your child is a sufferer, take note of the following:

 

·        Keep to a strict gluten-free

·        Monitor treatment. Once aglutencfreediet has beer) started, your child should be checked regularly with visits to a specialist clinic.

·        Make sure that your child sees a dietitian regularly

·        Add vitamins and extra minerals as recommended by your health-care team.

·        Regular blood tests will check the diet is effective.

·        A gut biopsy may be performed again if the child remains unwell.

 

For  More  Information:  Please  consult  your  physician  on  your  next  visit.