Celiac disease is an immune mediated reaction to gluten, a protein found in many everyday foods. Most children eat gluten containing products on a daily basis with no adverse reaction or intolerance. For children with celiac disease even modest amounts of gluten can cause inflammation to the inner lining of the gastrointestinal mucosa often leading to pain, bloating, constipation or diarrhea along with nausea. With ongoing exposure to gluten, children or adults at risk develop worsening intestinal inflammation preventing proper absorption of nutrients. If the disease is left unmanaged, a child with celiac disease can eventually develop nutritional deficiencies, as well as growth and development problems, other immune mediates diseases (thyroid disease, diabetes, skin disease) and long term can lead to gastrointestinal cancers. Definitive diagnosis requires endoscopy with tissue biopsy or possible skin biopsy if Dermatitis Herpetiformis is present.
IF YOU ARE BEING REFERRED TO WNY PEDIATRIC GASTROENTEROLOGY FOR AN EVALUATION OF CELIAC DISEASE, DO NOT START A GLUTEN FREE DIET. MAKE SURE YOU OR YOUR CHILD CONTINUE TO CONSUME GLUTEN CONTAINING FOOD PRIOR TO HAVING ANY BLOOD WORK OR ENDOSCOPY
Did you know…
that celiac disease is increasing in prevalence among children and adults. High risk populations are those with other immune mediated diseases such as diabetes, thyroid disease, psoriasis are more likely to develop or be diagnosed with celiac disease. In United States estimated prevalence of celiac disease among general population is 1:250 to 1:300. Risk is higher if there is family member with celiac disease or other immune mediated diseases.
The symptoms of celiac disease in children can vary depending on the severity of the disease and extent of inflammation. Many children and adults could have very mild, non specific symptoms such as abdominal pain, cramping, bloating, constipation or diarrhea. Some children may also suffer a loss of appetite, frequent bone fractures, frequent illnesses and weight loss.
Our physicians are highly trained and experienced in the diagnosis and treatment of pediatric celiac disease. They are actively involved in doing educational seminars to medical trainees and support groups in Western New York. Thorough history and blood work is often sufficient to establish an index of suspicion. With an exception of children or adults with prior diagnosis of Dermatitis Herpetiformis, endoscopy with multiple biopsies in the small bowel while on gluten diet or challenged with gluten is important for definitive diagnosis.
Unfortunately, there is no cure for celiac disease. However, most children and adults can live normal, healthy lives by adopting a strict compliance with gluten-free diets. Since gluten is found in wheat, rye and barley, these dietary ingredients are excluded from the diet. With increased recognition of celiac disease and attention to diet, many companies produce gluten free foods that include breads, pastas, pastries, cakes and many other products. We work with our patients regarding dietary changes, discuss compliance and establish routine follow up labs and imaging.