Humans have consumed gluten, the protein found in wheat, barley and rye, for at least ten thousand years. Only in the past decade has celiac disease and non-celiac gluten sensitivity captured the public’s attention with the rise of the gluten-free diet.
Celiac disease is a serious autoimmune disorder that requires a clinical diagnosis. A disease often misdiagnosed and incorrectly self-diagnosed, celiac entails an immune response to gluten, which results in the deterioration of the gastrointestinal lining and prevents proper absorption of vital nutrients.
Celiac disease can be difficult to diagnose because it affects people in different ways. A few children have no symptoms whatsoever, but most have one or more of the several hundred known symptoms and long-term complications that can occur in the digestive system or other parts of the body.
These include abdominal pain, diarrhea, malnutrition, growth failure, development of other autoimmune disorders like Type I diabetes and multiple sclerosis, anemia, osteoporosis, infertility and miscarriage, neurological conditions like epilepsy and migraines, and intestinal cancers.
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Myriad inflammatory bowel disorders, not just celiac disease or gluten intolerance, must be ruled out through a diagnostic process.
At Kentucky Children’s Hospital, the pediatric gastroenterology team provides the required individualized care that is crucial for children and their families diagnosed with celiac disease. Although some children with celiac disease are symptom-free, all children with celiac disease are still at risk for long-term complications, whether they display any symptoms or not.
At this time, lifelong adherence to a strict gluten-free diet is the only effective therapy to minimize symptoms and prevent complications of celiac disease. While gluten is not an inherently dangerous food property, even a small amount will disrupt the GI tract of people with celiac disease.
For parents who suspect their child is reacting to foods containing gluten, a simple blood test screening can suggest the presence of celiac disease with good accuracy. If a child tests positive, then a diagnosis will be made through an endoscopic biopsy, a procedure that allows physicians to see inside the GI tract. Myriad inflammatory bowel disorders, not just celiac disease or gluten intolerance, must be ruled out through a diagnostic process.
As with any disease that requires a dietary exclusion, parents must also ensure children with celiac disease on a gluten-free diet receive a balanced diet. Parents and caregivers should collaborate with their pediatrician and nutritionist to optimize nutritional choices for children diagnosed with celiac disease.
Like most inflammatory bowel diseases, the variant nature of celiac disease requires individualized and continuous pediatric care.
Dr. George Fuchs is a pediatric gastroenterologist at Kentucky Children’s Hospital.