What is celiac disease?

• Abdominal pain
• Blood tests
• Endoscopy
• Biopsy

About celiac disease

Celiac disease is a permanent condition in which the immune system reacts to gluten, a protein found in wheat, rye and barley. The small intestine is lined with villi, which are tiny fingerlike projections that help digest and absorb nutrients from food. In patients with celiac disease, gluten triggers an immune reaction that causes damage to the small intestine and villi and interferes with the body’s ability to digest and absorb nutrients.

Causes of celiac disease

This condition is caused by an immune response to gluten in genetically predisposed people. We don’t yet understand why celiac disease starts at a particular moment in a particular person.

Celiac disease prevalence

This condition affects 1 percent of the population.

Development of celiac disease

Celiac disease often develops after age 1, once a baby has transitioned from breast milk/formula to eating more solid foods that contain gluten. Symptoms of celiac disease can develop at any time

Symptoms of celiac disease

This condition’s symptoms can include:

• Diarrhea
• Abdominal pain
• Vomiting
• Constipation
• Enlarged abdomen
• Poor growth

But many patients have no symptoms when they are initially diagnosed based on bloodwork.

Risk of developing this condition

Caucasians are at higher risk for celiac disease. Children who have family members with celiac disease, who have genetic conditions such as Down syndrome or Turner syndrome, or who have an autoimmune condition like a thyroid disorder or diabetes are also at higher risk.

Concerns of celiac disease

Celiac disease causes malabsorption that can hinder your child’s growth and lead to failure to thrive. Repeated exposure to gluten can damage your child’s intestines, trigger another autoimmune disorder and increase your child’s risk of lymphoma. Patients with celiac disease also have a significantly higher mortality rate than the general population.

Diagnosis and evaluation celiac disease

The first step is a simple blood test that measures antibodies specific to celiac disease. This screening is only accurate if your child is currently eating foods that contain gluten, like most breads, crackers and pasta. To make a definitive diagnosis of celiac disease, your child’s doctor may use a procedure called endoscopy and take a biopsy sample from the small intestine. A pathologist will then examine these tissue samples under a microscope and report back to the gastroenterologist.

Treatment for celiac disease

This condition requires a strict, lifelong, gluten-free diet. After the diagnosis is made, your child’s doctor will refer you to a dietician who is knowledgeable about gluten-free diets.

Additional resources:

• “The Trouble that Jack Had” booklet for children
• Our services: Caring for children with celiac disease

After treatment

Fortunately, you can expect complete resolution of your child’s symptoms if your child adheres to a strict, gluten-free diet. Any damage to your child’s intestines from previous gluten exposure will heal. Your child should continue to see a gastroenterologist annually to make sure he or she hasn’t developed nutritional deficiencies because of the dietary restrictions.

Contacting a physician

Talk to your pediatrician if your child has persistent diarrhea, abdominal pain, a swollen belly, poor weight gain or other concerning symptoms. Celiac testing should be routinely done in family members of patients who have celiac disease and in patients with Down syndrome, type 1 diabetes or thyroid disease. Your physician may also opt to screen for celiac disease if other less common autoimmune conditions are present.

Long-term outlook for celiac disease

The outlook is good as long as your child follows a gluten-free lifestyle. Other than the need to avoid gluten, your child can lead a normal life.

Living with celiac disease

It’s important to follow your doctor’s advice regarding diet modifications. Fortunately, gluten-free products are easier to find than ever before as awareness of celiac disease grows and as more and more people decide to avoid gluten for other reasons.

For more information about this condition, visit the Celiac Disease Foundation.

Resources

Simply Gluten Free