Celiac disease is a problem that causes malabsorption—that is, a failure of the bowels to absorb nutrients. It’s caused by an immune reaction to gluten (the protein found in wheat, rye, barley, and, in some cases, oat products) that takes place in the intestine and stimulates the body’s immune system to attack and damage the lining of the intestine, preventing nutrients from being absorbed into the system. As a result, food simply passes through the intestines, only partially digested. The result is crampy abdominal pain, foul-smelling stools, diarrhea, weight loss, irritability, and a continuous feeling of being sick.
Treatment
Once your pediatrician has ruled out other possible digestive problems, he’ll order certain blood tests that can be used to screen for celiac disease. These tests measure the blood levels of antibodies to gluten. However, to make a definitive diagnosis, your pediatrician will refer your child to a pediatric gastroenterologist. This specialist will do a small-bowel biopsy, which entails the removal of a very tiny piece of the intestine for laboratory examination. This procedure usually is done by passing a small tube through the mouth and into the small intestine, where the biopsy is obtained.
If the intestinal lining turns out to be damaged, your child will be placed on a gluten-free diet. This means staying away from wheat, rye, barley, and some oat products. Your pediatrician or gastroenterologist will give you a complete list of foods to avoid, but you also need to carefully check the labels of any foods you purchase, since wheat flour is a hidden ingredient in many items. Because rice and rice products do not contain gluten, they’ll probably become a major part of your child’s diet. The number of gluten-free products in the grocery stores continues to increase, and some restaurants have gluten-free menus.
Incidentally, your child may not be able to tolerate milk sugar for as long as several months after the initial diagnosis is made. In this case, you may be advised to eliminate milk temporarily, as well as gluten products, from her diet. During this time she might be given milk treated with enzymes, so that it will be predigested before reaching the intestine. Extra vitamins and minerals also might be necessary.
If your child does have celiac disease, she must remain on a gluten-free diet for her entire life, completely avoiding wheat, rye, barley, and, in some cases, oat products.
