Anna K. Trauernicht, M.D., Boys Town Pediatric Gastroenterology
A child with celiac disease has a negative reaction to gluten, a protein found in some grains, including wheat, rye, barley and triticale. Eating foods containing or contaminated by gluten causes the small intestine to become swollen, damaging the villi (finger-like projections that assist the body in absorbing nutrients).
Anna Trauernicht, M.D. Pediatric GI
Celiac disease affects the small bowel and it makes it so the body doesn't absorb nutrients quite as well.
It can affect individuals from infancy to all the way through adulthood and it occurs in approximately one in 133 Americans. So, about one percent of the population has celiac disease.
The signs and symptoms can vary, quite significantly, from one person to the next. In some people you can have diarrhea and in others you can have constipation. You can have weight loss or weight gain. Often times you will have abdominal pain or belly pain and it's very hard to tell based on just symptoms alone.
The first way that we test for celiac disease is getting a blood sample. This can screen but the ultimate way we diagnose celiac disease is by doing an upper endoscopy, where we take samples of skin from inside the G.I. tract, to look for celiac disease.
For babies, they obviously can't tell us that they're having belly pain but we look for kids that have lots of spitting up or reflux. If they're having problems with growth or having difficulties with gaining weight, any of these things can give us a clue that we might need to screen for celiac disease.
You have to avoid all items that contain gluten and gluten, unfortunately, is in many, many foods. That's why we have you work with our dietician so you can go through and find all of the hidden sources of gluten.
There aren't any medicines you need to use. If you make the change in your diet, you'll be able to treat the celiac disease.
The symptoms of celiac disease vary greatly, making it difficult to diagnose. In fact, it is possible to have the condition without showing any symptoms at all (this is called silent celiac disease). Digestive symptoms are more commonly seen in kids than adults. Symptoms vary greatly between individuals and can include a combination or none of the symptoms below.
Again, symptoms vary greatly and come in no specific order or combination. If you suspect that your child has celiac disease, schedule an appointment with your pediatrician.
Do not change your child’s diet before your appointment, as this could change the results of celiac disease tests. You may want to have your child tested for celiac disease if the condition runs in your family or if you observe the following symptoms in your child:
Blood tests are used to screen for celiac disease. You must be on a diet containing gluten prior to your blood screening for the test results to be accurate.
If a positive blood test is confirmed, your doctor will confirm the results of your screening with an endoscopy.
Once diagnosed with celiac disease, patients must learn to maintain a gluten-free diet for the rest of their lives. Failure to do so may result in malnutrition, decreased bone density due to calcium loss, miscarriages or infertility, lactose intolerance and certain types of cancer. Your pediatrician may also prescribe vitamin supplements, steroids or skin medication.
Gluten-free foods are becoming increasingly common, but if you are concerned about maintaining a gluten-free diet for your child, ask your pediatrician about meeting with a dietician to discuss menu options, foods to eat when dining out and what to look for when grocery shopping.