CELIAC DISEASE

Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate a protein called gluten, found in wheat, rye, and barley. Gluten is found mainly in foods but may also be found in products we use every day, such as stamp and envelope adhesive, medicines, and vitamins.

When people with celiac disease eat foods or use products containing gluten, their immune system responds by damaging the small intestine. The tiny, fingerlike protrusions lining the small intestine are damaged or destroyed. Called villi, they normally allow nutrients from food to be absorbed into the bloodstream. Without healthy villi, a person becomes malnourished, regardless of the quantity of food eaten.

Because the body’s own immune system causes the damage, celiac disease is considered an autoimmune disorder. However, it is also classified as a disease of malabsorption because nutrients are not absorbed. Celiac disease is also known as celiac sprue, nontropical sprue, and gluten-sensitive enteropathy.

Celiac disease is a genetic disease, meaning it runs in families. Sometimes the disease is triggered—or becomes active for the first time—after surgery, pregnancy, childbirth, viral infection, or severe emotional stress.

CELIAC DISEASE - SYMPTOMS -

The symptoms of celiac disease in children typically become apparent three to five months after first consuming gluten- containing foods although for some few cases, the interval may be as short as one month. Several of the experts on infant feeding advise that solid foods should not be introduced to a baby’s diet until nearly five months old and that gluten-containing cereal should be avoided for the first six months of life.

The celiac, but otherwise normal baby, thrives until gluten is introduced into the diet and then begins to refuse feedings and fails to gain weight. The child may gradually become irritable or listless and develop a large abdomen. The stools will typically become abnormal, perhaps large, pale and offensive, or representative of a loose-like diarrhea. Stools generally float because of the high content of air and fat. The child may also vomit from time-to-time or in some cases exhibit forceful projectile vomiting with the consumption of selected gluten-containing foods. Many children lose weight or have a failure to gain weight and the buttocks become flattened. Some few children may become quite ill with acute diarrhea and dehydration. Symptoms vary and are different from one celiac child to the next with no two being alike in how the condition “acts out” for them and in their bodies.

Older children with more subtle symptoms of poor appetite, poor growth, and anemia are much more difficult to diagnose as there are many other reasons for failure to grow in childhood. Clinical symptoms often diminish or disappear during puberty [adolescence], although biochemical or morphologic abnormalities of the celiac condition may persist. More active symptoms will again reoccur in early adult life following the period when the immune system appears to “give more of its attention” to sexual develop- ment. While the teen may feel that he or she has “grown out of the disease,” the actuality is that the condition continues and should [must] be treated with the same strict gluten-free diet.

What happens to people with celiac disease?

Celiac disease can cause different problems at different times:

• An infant with celiac disease may have abdominal pain and diarrhea (even bloody diarrhea), and may fail to grow and gain weight.
• A young child may have abdominal pain with nausea and lack of appetite, anemia (not enough iron in the blood), mouth sores and allergic dermatitis (skin rash).
• A child could be irritable, fretful, emotionally withdrawn or excessively dependent.
• In later stages, a child may become malnourished, with or without vomiting and diarrhea. This would cause the child to have a large tummy, thin thigh muscles and flat buttocks.
• Teenagers may hit puberty late and be short. Celiac disease might cause some hair loss (a condition called alopecia areata).
• Lactose intolerance (problem with foods like milk) is common in patients of all ages with celiac disease.
• Dermatitis herpetiformis (an itchy, blistery skin problem) is also common problem in people who have celiac disease.