Today, many people are interested in the question of what is celiac disease. The symptoms and causes of this disease really need to be known. After all, quite often such pathology is detected in childhood.

So what are the main mechanisms of the disease? What treatment methods does modern medicine offer? Can the patient expect a normal quality of life? The answers to these questions will be of interest to many.

What is celiac disease?

Celiac disease is considered a fairly rare disease today. This is a congenital disease, which in medicine is often called celiac enteropathy. Essentially, the disease is a digestive disorder in which the villi of the small intestine are damaged due to exposure to specific proteins that enter the digestive tract along with certain grain products.

Some historical data

Some experts believe that this disease appeared relatively recently. But in fact, historical evidence suggests that humanity has long known a disease called “celiac disease.” Its symptoms were first identified in the first century AD. Caelius Aurelius and Aretaeus in their works described steatorrhea and chronic diarrhea, from which mainly children and women suffered. At the same time, the disease received its name “morbus coeliacus”, which translated means “intestinal disease”.

More recent information was published in a scientific publication in 1888. Samuel Guy, a doctor at the Bartholomew Hospital in London, described the main signs of celiac disease in children, in particular, mentioning anemia, exhaustion, diarrhea, and various developmental disorders. But the Dutch pediatrician Willem Dick succeeded in linking digestive disorders with gluten consumption in 1950. The first diet plan for people with this disorder was developed two years later.

As for modern statistics, they indeed confirm that cases of celiac disease are being observed more and more often. On the other hand, such a sharp increase in the number of patients may be associated with the development of new tests and examination methods.

By the way, it has been proven that in women this disease is diagnosed much more often. It is believed that approximately 1% of humanity suffers from celiac disease. Moreover, in some the disease has truly pronounced manifestations of intestinal disorders, while in other patients only some secondary symptoms are observed.

Main causes and mechanisms of disease development

Celiac disease is associated with intolerance to certain proteins found in cereal products. Such protein substances destroy the villi lining the mucous membrane of the small intestine, which leads to serious digestive disorders. Potentially dangerous substances are gluten (found in wheat), secalin (rye), hordein (barley), avenin (oats).

Unfortunately, to date, the mechanisms of development of such a disease have not yet been sufficiently studied. However, there are several main theories. In particular, it has been proven that intolerance to this group of proteins is hereditary. In addition, there is evidence that celiac disease develops against a background of malfunctioning of the immune system.

On the other hand, some scientists attribute some congenital pathologies and anatomical features of the small intestine to risk factors. There is also a theory that connects the development of hypersensitivity to protein with infections suffered during intrauterine development.

In any case, celiac disease is a chronic disease. And, unfortunately, modern medicine does not know any means that can permanently get rid of such a disease.

Celiac disease: symptoms in children

What does this disease look like in children? What signs should lead parents to believe that their baby has celiac disease? Symptoms usually appear in the first year of a baby's life. Most often, they appear at the stage of introducing complementary foods, in particular, semolina porridge, oatmeal decoctions, some artificial mixtures and other products containing gluten and other potentially dangerous proteins.

• The first sign of the disease is frequent loose stools. Feces, as a rule, are mixed with foam and often have an extremely unpleasant fetid odor.
• There is one more symptom that accompanies celiac disease. The photo above demonstrates that a sick child may experience a significant increase in abdominal circumference. By the way, such a disorder is observed in approximately 80% of cases.
• Most children also complain of severe abdominal pain. The pain is localized in the area near the navel. Increased discomfort is usually observed after eating, and the pain reaches its peak 3-5 hours after eating.
• Signs may also include appetite disturbances. At times the child refuses to eat at all, and after some time the appetite increases sharply - the baby can eat much more than the average portion.
• Due to digestive disorders, there is also a delay in weight gain.
• In approximately 60-70% of cases, celiac disease in children is associated with one or another type of allergy. Most young patients develop atopic dermatitis. Bronchial asthma and other respiratory allergies are also possible.
• Due to phosphorus and calcium deficiency, the musculoskeletal system also suffers. The child may complain of bone pain, which worsens at night or after physical activity. You can often notice damage to tooth enamel, as well as caries. Even the slightest injury can break a bone. Sometimes celiac disease in a child is associated with the development of rickets, osteoporosis and other lesions of bone and muscle tissue.
• Naturally, the nervous system suffers from a deficiency of vitamins and minerals. Children often become too irritable. There are problems with sleep - the baby often wakes up at night. Aggressive behavior is also typical. On the other hand, apathy and insensitivity to external factors may appear.

Without proper treatment, celiac disease leads to delayed physical, mental and intellectual development.

Celiac disease: symptoms and clinical features in adults

As mentioned above, this disease is congenital. However, not all patients have it in childhood. If celiac disease is diagnosed in adults, this usually indicates a hidden course of the disease and a blurred clinical picture. Indeed, many people live to adulthood without even knowing about their illness.

Of course, the symptoms of celiac disease in adults in this case will differ from those described above. In particular, obvious signs of digestive disorders may be completely absent. In most cases, suspicion of the presence of such a disease arises due to the presence of secondary disorders.

For example, celiac disease in adults often leads to the development of anemia, and its origin cannot be explained. In addition, patients often complain of constant fatigue, weakness in the body, pain in the joints and muscles, which significantly spoil life, interfering with active recreation. Symptoms may also include problems with sleep, constant depression, decreased performance, apathy, and irritability. Sometimes a deficiency of nutrients even leads to the development of depression.

During exacerbations, some digestive disturbances can also be observed. The main signs include frequent bowel movements and the appearance of loose stools with foam and large, undigested pieces of food. By the way, exacerbation of the disease can be triggered by infectious diseases, surgical procedures, severe stress or overexertion.

Diagnosis of the disease

How is celiac disease determined? Diagnosis of this disease can be fraught with some difficulties. But in any case, a patient suspected of having such a disease must undergo a full examination.

To begin with, as a rule, immunological blood tests are performed, which indicate the presence of certain specific antibodies that are produced in the body during a similar disease. Adult patients usually require a complete gastroenterological examination, which allows examination of the mucous membrane. The most accurate results can be obtained using a tissue biopsy of the small intestine - the resulting samples are then examined in the laboratory. But this procedure is associated with some risks, so doctors prescribe it only in extreme cases.

Naturally, there are also some auxiliary methods. For example, patients are advised to undergo genetic testing, which can determine whether the patient has potentially harmful genes. Such tests not only help make a diagnosis, but are also important for statistical collection of information.

What other test for celiac disease will need to be taken? Stool studies are also important. For example, assessing the amount of lipids in excrement helps distinguish intestinal pathologies from pancreatic diseases. And determining the level of carbohydrates in stool makes it possible to assess the degree of malabsorption of carbohydrates in the intestines.

In any case, it is worth understanding that the results of such surveys are relative. The most accurate method is to check the condition of the patient’s body after switching to a gluten-free diet. After a few months (sometimes even a few weeks), significant improvement occurs.

It is worth noting that in modern medicine they often encounter certain difficulties when diagnosing a disease called “celiac disease”. The symptoms of this disease often resemble some other, more common pathologies. In particular, it is easily confused with a number of autoimmune diseases, as well as various digestive disorders, metabolic disorders, damage to the endocrine system, etc.

Is there an effective treatment?

What treatment does celiac disease require? Treatment in this case has several main goals. First, you need to try to restore the function of the small intestine. Secondly, it is important to eliminate deficiencies of nutrients, vitamins and minerals. If we are talking about a sick child, then it is necessary to restore normal rates of physical and mental development.

In the most severe cases, patients require hospitalization and parenteral nutrition. Additionally, preparations of folic acid, calcium, iron and salts are administered. Sometimes the use of certain hormonal drugs is required. However, the basis of therapy is nutrition.

Diet is the key to the patient’s well-being

How is celiac disease treated? Diet is the patient’s only chance to avoid complications. Indeed, in the absence of appropriate nutrition, even the most modern medications will not be able to cope with the main symptoms of the disease.

How is celiac disease treated in children? Babies in their first year of life are usually given artificial nutrition. Moreover, mixtures based on soy or casein hydrolyzate are considered suitable. As you grow older, “safe” foods are gradually introduced into your diet.

In any case, it is imperative to exclude gluten-containing products from the menu. This is wheat, rye, barley and oats, as well as all their derivatives in any form (including bread, sweets, sausages, some sausages and canned food). In addition, you should not eat foods rich in potential allergens. It is also worth excluding from the diet foods that stimulate fermentation processes in the intestines.

As for the permitted foods, these are rice, potatoes, buckwheat, legumes, corn, as well as milk, eggs, meat, etc. During an exacerbation, doctors recommend a gentle diet, in which the patient should take warm boiled or stewed food, preferably in shabby condition.

Possible complications of celiac disease

It is immediately worth noting that this disease, in the absence of the necessary therapy, can lead to a lot of complications. After all, digestive disorders lead to a deficiency of nutrients, vitamins, hormonal imbalances, etc.

Quite often, patients who do not adhere to an appropriate diet develop vitamin deficiencies, iron deficiency anemia and, accordingly, the ensuing problems, including a significant decrease in immune activity. Patients with this diagnosis are more susceptible to infectious diseases.

In addition, complications include ulcerative lesions of the jejunum and ileum. In some cases, hyposplenia is observed - a decrease in the spleen and disruption of its functioning. The likelihood of developing malignant intestinal diseases increases significantly. Adult patients also often suffer from infertility. Due to nutrient deficiency, hypotension, chronic fatigue, constant drowsiness, decreased performance, depression, etc. appear.

What are the forecasts?

In fact, celiac disease in children and adults in most cases can be quite easily corrected with the help of a proper diet and taking multivitamin complexes. Therefore, the prognosis for patients with this diagnosis is most often favorable. Various complications and the development of concomitant diseases are usually observed in advanced forms of celiac disease.

Celiac disease in children is a hereditary disease that affects the intestinal mucosa due to intolerance to gluten, which is found in large quantities in cereals. Often this disease develops in children starting from the age of two; the signs are mild, but as the disease progresses they become more pronounced. In some cases, the first symptoms can be noticed in an infant who has an intolerance to cow's milk. After eliminating foods containing gluten protein from the diet, the condition improves and returns to normal within a year.

The exact reasons for the progression of this disease in children have not been established, but it is believed that predisposing factors are genetic predisposition, autoimmune diseases that have a negative effect on the intestinal mucosa, and some types of viral infections. The main manifestations of this syndrome are considered to be lack of appetite and loss of body weight, liquid and foamy stool, increased abdominal volume, delayed growth and sexual development.

Diagnosis of the disease is based on laboratory studies of stool and blood, intestinal biopsy and instrumental examinations of the child. Treatment of this syndrome is based on following a special diet, taking a vitamin complex and enzymes to improve the functioning of the digestive system. Without timely treatment, the disease can cause disability or death of the child.

Etiology

The main cause of gluten intolerance syndrome is genetic disorders that create favorable conditions for damage to the structure of the intestinal mucosa when consuming certain grains. There are several favorable factors contributing to the development of the disease:

• the presence of a similar disorder in close relatives;
• autoimmune diseases of the thyroid or pancreas, against which the immune system attacks its own cells;
• an inflammatory process in the intestine, due to which lymphocytes accumulate in the cells of this organ;
• wide range;
• prolonged influence of stressful situations on the child;
• complications after surgery, for example, after removal.

However, the exact reasons for the formation of the disease in children are not fully known.

Varieties

In modern medicine, there are several forms of celiac disease in children:

• typical – there are disturbances in the functioning of the gastrointestinal tract and intolerance to any dairy products;
• atypical – symptoms of the disease may not appear at all;
• hidden - in most cases it occurs without expressing any signs;
• latent – ​​manifestations of the disease are completely absent. Diagnosis is carried out by studying blood and stool tests;
• refractory – accompanied by pronounced symptoms. It differs from other forms in that if the diet is followed, there is no improvement in the child’s condition. This causes disability or death.

Symptoms

The primary manifestation of the syndrome is not immediately apparent. In infants, signs begin to appear when complementary foods are introduced, when gluten-containing foods are added to the diet. The symptoms of the disease make themselves felt more clearly in babies under one year old - starting from eight months. In some children, characteristic features appear closer to three years.

Signs of this disorder in children under two years of age:

• liquid feces containing particles of fat and foam. They often have a persistent unpleasant odor;
• increase in abdominal volume;
• attacks of nausea ending in vomiting;
• lag in growth and weight gain compared to healthy peers;
• constant tearfulness and agitation of the child;
• delay in psychomotor development - children later than others begin to hold their heads independently, show interest in new toys and people, crawl and walk.

Symptoms of the disease in children over two years of age and adolescents:

• diarrhea, alternating;
• pale skin;
• increased fatigue;
• delayed puberty. Girls may start menstruating by age fifteen or later. There is insufficient development of the mammary glands;
• stunted growth - in girls it does not exceed 155 cm, in young people - 165 cm;
• allergic reactions - the appearance of a characteristic rash on the skin;
• – there is a decrease in bone density. Occurs in half of children diagnosed with celiac disease. After eliminating grains, bone density is restored. The entire process takes no more than one year. In some cases, it may become a factor in the occurrence of disability;
• increased hair loss.

Complications

With late diagnosis and treatment of the disease, as well as non-compliance with the diet, there is a possibility of developing the following complications:

• persistence of symptoms of this disorder even when all rules regarding nutrition are followed;
• formation of ulcers of the small intestine;
• infertility – observed in severe cases of the disease;
• deficiency of vitamins in the body;
• significant mental and mental retardation;
• increasing the likelihood of oncology of the gastrointestinal tract;
• frequent bone fractures or disability – due to decreased bone density;
• lethal outcome - with the rapid development and severe course of celiac disease in children under two years of age.

By following a gluten-free diet throughout your life, many of the above consequences can be avoided.

Diagnostics

The specialist establishes the primary diagnosis based on examining the patient, identifying the possible causes of the formation of diseases, the presence and intensity of certain symptoms. The examination includes measurement of height and body weight, palpation of the abdomen. Laboratory tests are of primary value in diagnosing celiac disease in children:

• blood – general and biochemical;
• microscopic and bacteriological examination of feces;
• genetic tests.

Instrumental methods to confirm the diagnosis include an intestinal biopsy, during which a small piece of the mucous membrane is taken for subsequent detailed examination. FGDS - allows a specialist to examine and evaluate the structural condition of the gastrointestinal tract. Ultrasound of the abdominal organs - to search for and confirm the presence of intestinal damage and digestive disorders. Densitometry - allows you to determine the density of bone tissue.

In addition, consultation with an allergist-immunologist is necessary. During diagnosis, some specialists ask not to give the child foods containing gluten for several days, after which they repeat some tests and assess the patient’s general condition. When indicators change for the better, the diagnosis "" is established with accuracy.

Treatment

Treatment of celiac disease in children necessarily involves a lifelong avoidance of grains containing gluten, such as wheat, barley and rye. Completely exclude semolina, pasta and bakery products based on flour from the above cereals. In addition, it is worth limiting the consumption of sausages, smoked meats, ice cream, chocolate, various sauces, ketchups and mayonnaise, coffee and cocoa, and canned food. This is due to the fact that they may also contain this protein. It is allowed to take products made from rice and corn flour, as well as potatoes, fish, meat and fruits. If you follow proper nutrition, the first improvements are visible within a month - complete restoration of the intestinal mucosa occurs throughout the year.

In addition, treatment of this syndrome is aimed at eliminating symptoms not related to the gastrointestinal tract. Often patients are prescribed:

• drugs to increase hemoglobin levels;
• medications containing calcium and vitamin D - necessary to strengthen bone tissue. Normalization of bone density is achieved in about a year. Otherwise, increased bone fragility can lead to disability;
• vitamin complexes.

If necessary, courses of therapy are prescribed by a psychotherapist. With timely and correct treatment, the prognosis of the disease is favorable.

Prevention

There is no specific prevention of celiac disease in children; it is only necessary to follow a diet throughout life, and in the future give up bad habits - drinking alcohol and smoking. To confirm the hereditary factor and the presence of predisposing factors, you need to undergo regular examinations by specialists - at least twice a year. If the first signs of the syndrome occur, immediately contact a medical facility. The sooner treatment begins, the higher the likelihood of a full recovery and the absence of undesirable consequences, including disability and death.

Is everything in the article correct from a medical point of view?

Answer only if you have proven medical knowledge

Celiac disease or celiac disease is an allergic disease in which the intestines cannot accept and absorb foods containing gluten. Celiac disease is considered a congenital disease that is transmitted from parents to child, but the mechanisms of development of the disease have not yet been fully elucidated.

With celiac disease, gluten entering the intestines is not completely broken down, and as a result of incomplete breakdown, toxic substances are formed that injure the inner surface of the intestine. In young children, celiac disease begins to develop with the introduction of complementary foods, which parents can determine by: vomiting, foamy stools, worsening weight gain, and bloating.

In the adult population, celiac disease is disguised as diseases of the intestines and stomach, which are chronic. In such cases, the patient can unsuccessfully treat unstable stools, flatulence and other diseases associated with dyspepsia for a long time, unaware of gluten intolerance.

That is why official statistics are significantly underestimated and represent a percentage of cases equal to 1:1000. It is also widely believed that celiac disease is not a disease, but a lifestyle that requires diet, because without contact with gluten, the development of celiac disease is impossible. The most toxic part of broken down gluten is gliadin (the alcohol soluble fraction).

Interesting facts about the disease

Celiac disease began to exist from the moment humans began to eat cereals (rye, wheat), so the age of the disease goes back several thousand years.

Women are more susceptible to the development of celiac disease, and it practically does not occur in Africans, Japanese and Chinese. Most likely, this is due to dietary habits or a genetic component.

Some regions of Russia still do not recognize celiac disease as a pathology, and doctors are prohibited from making such a diagnosis.

Some experts classify celiac disease as a precancerous condition, which increases the risk of developing digestive cancer, small intestinal lymphoma, and intestinal bleeding.

If parents suffer from celiac disease, the risk that the child will have this pathology after birth is 1:10.

Causes

The exact causes of celiac disease are still unknown, but there are several theories about the occurrence of this disease. The most common are immunological and enzymatic, with the first being supported by most researchers.

Immunological

Autoimmune antibodies to the cell structures of the intestinal lining and antibodies to gluten appear in the blood. In the presence of celiac disease, the number of intraepithelial lymphocytes with a specific set of receptors is increased. It is these cells that mistakenly identify gluten as a threat and damage the intestinal walls.

Enzymatic

The small intestine lacks the enzyme that breaks down gluten. This is a very likely reason, but has not been fully proven for the reason that following a diet leads to the restoration of intestinal enzymatic function.

• Viral theory

According to research by scientists, about 90% of patients with celiac disease have an increased number of antibodies to a certain type of adenovirus. However, you should not believe your doctor if he says that celiac disease is caused by an adenovirus. It has nothing to do with a congenital disease; gluten is simply antigenically similar to an adenovirus.

Pathoreceptor

It is based on the assertion that the intestines have an abnormal protein composition, which leads to excessive sensitivity of the small intestine to gluten.

Most scientists agree that the proposed picture of gluten intolerance includes all theories and unites them: there is no enzyme - gluten is not broken down and accumulates, which leads to a toxic effect on the intestines, which responds by reacting cells with special receptors. Such cells perceive gluten as a threat and attempts to destroy it lead to damage to the intestinal walls, which disrupt the process of digestion and absorption of food. In this interpretation, an adenovirus is considered a possible initiator of the body’s immune response to gluten.

Symptoms

In the medical literature, three forms of clinical manifestation of celiac disease are distinguished. The real picture of the disease has a variety of manifestations: celiac disease can masquerade as various gastrointestinal diseases, dermatological pathologies, hypovitaminosis and others. It is due to the variety of symptoms that celiac disease is diagnosed in a limited number of patients, while a larger number of patients with celiac disease continue to be treated for false, but similar in symptoms, diseases.

At the same time, there are cases when all tests and clinical manifestations confirm the presence of celiac disease in a patient, but after a biopsy of the small intestine, the doctors’ diagnosis is not confirmed.

It is also worth noting that the earlier foods containing gluten are introduced into food and the more of them there are, the faster celiac disease will begin to develop, and the nature of the course of the disease will be much more complex.

Symptoms of celiac disease in children

The typical form of celiac disease is characterized by three striking symptoms:

Frequent stool (5 or more times a day), while it has a mushy consistency, smells bad, foams, has different colors, shiny inclusions of fat, is difficult to wash off and there is quite a lot of it.

Protruding belly. Parents think that this is because the child eats well; the doctor may say that the reason is the child’s development of rickets.

Presence of retardation in weight and height. Particularly noticeable is the lag in weight in the first two years of life and a noticeable lag in growth after reaching the age of two. In this case, a lack of weight gain begins to be observed after the introduction of complementary feeding, although before complementary feeding, weight gain occurred at a normal pace.

Other symptoms that confirm the presence of celiac disease in a child are associated with a lack of nutrients, microelements, and vitamins. For each specific case it may be different:

Lethargy, fatigue or, conversely, increased irritability, aggressive behavior, tearfulness.

Unsatisfactory condition of the skin and hair: atopic dermatitis, flaking of the skin, dryness, weakness.

The child is susceptible to frequent fractures at the slightest opportunity. It should be borne in mind that a healthy child’s bones are much stronger than those of adults due to their elasticity.

Insufficient muscle tone (hypotonia).

Incorrect posture.

• The appearance of oral cavity pathologies: stomatitis, caries, enamel fragility, bleeding gums.

  The child has a characteristic – unhappy appearance.

  The child has thin limbs and a large belly, which is why such children are compared to spiders.

As a child with celiac disease grows up, disturbances in the functioning of the reproductive system are observed: in boys - sexual dysfunction, in girls - absence of menstruation.

Symptoms of celiac disease in adults

The symptoms of celiac disease in the adult population are characterized by a latent and atypical form. The manifestation of an atypical form is possible only after 30-40 years of life. This form of the disease is characterized by the presence of one of the main symptoms of the typical form of the disease and several accompanying ones. In general, extraintestinal manifestations of the disease come to the fore:

Dermatological: atopic and herpetiform dermatitis.

Neurological: depression, migraine.

Reproductive: infertility.

Joint: pain in the joints, the cause of which cannot be explained, arthritis.

Renal: nephropathy.

Changes in biochemical blood test: increase in albumin, transaminases, alkaline phosphatase, decrease in cholesterol.

Clinical studies have shown that 4-8% of women who have undergone infertility treatment without success suffer from celiac disease. After introducing a gluten-free diet, they were all able to give birth to a child.

The latent form of the disease may not manifest itself in any way, except for irregular intestinal problems or skin problems (dermatitis), which no one can associate with the disease. Therefore, celiac disease is detected only through random examination.

Complications that occur with gluten intolerance

A long-term course of the disease in a latent form leads to an increased risk of developing serious diseases:

Autoimmune hepatitis, autoimmune thyroiditis.

Type 1 diabetes mellitus.

Rheumatoid arthritis.

Oncology of the gastrointestinal tract.

Recurrent pericarditis.

Scleroderma, myasthenia.

Diagnosis of the disease

In most cases, celiac disease is detected during a comprehensive diagnosis of the body in the process of confirming the diagnosis of one of the diseases listed above. Targeted diagnosis of celiac disease includes three stages:

The first is an immunological test of the patient’s blood. During the study, the presence of tissue transaglutaminase, autoimmune bodies to reticulin, endomysium, and the level of antigliadin antibodies are determined.

The second - if the first stage has positive test results, then a biopsy of the small intestinal mucosa is performed, which includes determining the presence of lymphocytes with atypical receptors, inflammation, and the general condition of the villi. The second stage is the most important for making a correct diagnosis.

The third is prescribing a gluten-free diet and observing the patient with a doctor for 6 months. If the general condition improves, a reverse development of the symptoms of the disease is observed - the diagnosis is 100% confirmed.

The peculiarity of the treatment is that even with negative biopsy results, the patient with positive immunological tests is assigned to the third stage of diagnosis. If the patient’s condition improves within six months, the diagnosis of celiac disease is confirmed, and this form of the disease is called potential.

A repeat immunological examination is carried out a year later, and positive dynamics are expected. After two years, a repeat biopsy should confirm complete restoration of the small intestinal villi.

Differential diagnosis

Doctors are usually in no hurry to diagnose celiac disease, much less prescribe an intestinal biopsy. Initially, celiac disease must be distinguished from hereditary intestinal diseases, intestinal infections, immunodeficiencies, and food allergies.

Celiac disease differs from the listed pathologies due to the good effect of following a gluten-free diet (prescribed in case of a positive response to an immunological examination of atypical antibodies), and the absence of blood and mucus in the stool.

Treatment

Lifelong adherence to a gluten-free diet is the only effective treatment. A typical diet for celiac disease involves the exclusion of baked goods, confectionery products, cheap sausages, sausages, cutlets, sauces, some cereals (semolina, pearl barley, oatmeal), and pasta. Gluten can also be hidden in beer, kvass, malt extract, dyes, coffee, cocoa, canned food, ice cream, cottage cheese and yoghurt, cheese, ketchup, and mayonnaise.

Critical for an allergy sufferer is the content of more than 1 milligram of gluten per 100 grams of product.

Permitted for use:

Natural dairy products, eggs.

• Fish, meat.

  Fruits vegetables.

  Millet, corn, buckwheat.

  Marmalade, chocolate.

For children, special mixtures are prescribed that contain soy or casein hydrolysate. To introduce dietary complementary foods, special gluten-free cereals are used. Once a diagnosis has been made, therapy is limited to reducing symptoms:

Improving digestion with the help of pancreatic enzymes (Pancreatin, Creon).

Correction of intestinal microflora: prebiotics (Hilak Forte), probiotics (Actimel, Linex, Bifiform), intestinal antiseptics (Enterofuril).

Treatment of diarrhea: Imodium, Smecta, oak bark decoction.

Treatment of bloating: Plantex, Espumisan.

Therapy for hypovitaminosis: vitamins K, D, E, B, A, nicotinic acid (in severe cases), multivitamins orally are administered intravenously.

Treatment of malnutrition: increasing calorie intake, nutrition correction.

Elimination of protein deficiency: albumin, mixtures of amino acids.

Correction of water-electrolytic balance: calcium gluconate, Panangin.

Treatment of autoimmune diseases with glucocorticosteroids.

The patient undergoes simultaneous therapy for celiac disease and monitoring for concomitant diseases, for example, diabetes.

Under no circumstances should you take medications (pills and tablets) whose shell contains gluten (for example: Festal, Mezim Forte, Complivit). It is also worth paying attention to the composition of liquid preparations and excluding preparations containing malt (Novo-passit), which is contraindicated for use by patients with celiac disease.

Celiac disease is not a death sentence

Most children, when the diagnosis of celiac disease is confirmed, become disabled, but in the case of strict adherence to a properly designed diet, the prognosis is quite favorable. After a few weeks, the intestinal symptoms of the disease go away, and during the first couple of months the protein, water-electrolyte, vitamin-mineral balance is completely restored.

A child who follows all the points of treatment for the disease is able to catch up with his peers in height and weight. However, adherence to a gluten-free diet should be carried out for life, because poor nutrition, and with it the progress of the disease, can lead to the development of oncological diseases of the gastrointestinal tract and the return of all pathological phenomena.

If your baby periodically experiences digestive disorders for no apparent reason, it is worth checking him for celiac disease, that is, gluten intolerance. Such symptoms are characteristic of this disease. Nowadays it is common, although it has been known to people since ancient times.

A timely diagnosis and adherence to a special diet will help improve the child’s quality of life and allow him to forget about abdominal pain and bowel movements. Although celiac disease is a lifelong disease, it does not cause complications and is not life-threatening.

What is celiac disease and what are the causes of its occurrence in children?

Celiac disease in children is a disease whose characteristic symptom is intolerance to gluten (cereal protein), associated with thinning of the mucous membrane of the small intestine. In medical terminology, celiac disease goes by several names - celiac enteropathy, Guy-Herter-Heubner disease, non-tropical sprue.

The small intestine digests food, after which beneficial nutrients enter the body. Gliadin, contained in cereal protein, activates the immune system, resulting in inflammation and atrophy of intestinal tissue. The disease is incurable, but completely eliminating gluten will prevent it from developing and completely restoring the mucous membrane.

Celiac disease should not be confused with an allergic reaction to wheat. Completely different principles apply here: allergies lead to skin rashes due to the immune system’s reaction to an allergen, and with celiac disease, the human body cannot absorb the protein of cereals.

The main cause of celiac disease in children is heredity. There are categories of children who are more susceptible to this disorder than others; they suffer:

• diabetes mellitus type 1 (see also:);
• Down syndrome or Shereshevsky syndrome;
• autoimmune diseases of the thyroid gland;
• Addison's disease;
• rheumatoid arthritis (more details in the article:).

Types and symptoms of the disease

Symptoms of celiac disease do not appear immediately after birth, but during the consumption of foods containing cereal protein. It is diagnosed mainly in children, very rarely in adults.

It can be true, that is, genetically determined, or it can be a sign of other diseases (infectious, inflammatory bowel diseases, gastrointestinal abnormalities). Some experts associate celiac disease with harmful environmental conditions in the urban environment.

In children of the first year of life, celiac disease is typical, that is, it has all the characteristic symptoms of the disease. It appears after introducing gluten-containing products into the child’s diet. The first reaction makes itself felt 6-8 hours after eating.

An infant is often bothered by the following symptoms:

• the stool becomes foamy and has the consistency of porridge;
• frequent colic, bloating;
• excessive frequent regurgitation;
• poor weight and height gain, sometimes rickets;
• late teething (we recommend reading:).

Children of preschool age and older suffer from:

• diarrhea, constipation, bloating, excess gas;
• nausea, vomiting;
• abdominal pain;
• decreased appetite;
• poor weight gain and height;
• anemia;
• skin rashes - dermatitis herpetiformis, which is accompanied by severe itching, burning and blisters in certain areas of the skin (you can see what it looks like in the photo);
• problems with teeth (changes in enamel color, the appearance of grooves and pits, caries), thinning of bones - this is due to poor absorption of vitamin D;
• in adolescence;
• attention deficit hyperactivity disorder.

The initial stage of the disease is not always detected; it can be confused with signs of other diseases. As a rule, in infants up to 3 months, such phenomena are attributed to newborn colic or a change in diet (for example, the introduction of formula).

Symptoms of pathology during life may also be implicit, that is, expressed by completely different signs. Then they talk about an atypical form of celiac disease. There are asymptomatic and latent forms of the disease, which do not manifest any symptoms and are diagnosed only with a biopsy of the small intestine. They are detected, as a rule, in older people and come as a surprise to the person being examined. Sometimes the latent form of celiac disease is activated during periods of stress, pregnancy, inflammatory processes, and operations.

Diagnostic methods

According to statistics, only 20% of all those suffering from this disease consult a doctor. However, timely detection of a disorder can significantly improve the patient’s quality of life. Diagnosis of celiac disease is carried out based on the symptoms of the disease and the results of examinations, which are prescribed by the therapist:

Before the diagnosis, the child should eat as usual, without avoiding foods with gluten, otherwise the test results will not be reliable. This is due to the fact that the intestinal mucosa is able to quickly recover in the absence of an irritant.

Features of treatment for children of different ages

The main thing in the treatment of celiac disease is a gluten-free diet. If it is followed, the child begins to grow fully and gain weight, vitamins are absorbed, bones and teeth become strong. The diet helps 70% of patients with celiac disease, for them it will be the only and lifelong means of therapy.

If following a diet does not help, and the health of the sick child worsens, the doctor will prescribe medications. This occurs due to food contamination with traces of gluten, so the diet should be planned in conjunction with a pediatric nutritionist. He will tell you which products are safe for the baby. Considering the hereditary component of the disease, close relatives of a sick child should also be tested for celiac disease.

Special diet

The diet involves the complete exclusion of foods containing gluten from the diet:

• flour, including rye flour;
• porridge - semolina, wheat, oatmeal (it is introduced carefully after some time), barley;
• food colorings, preservatives;
• starch;
• sauces, ketchup;
• sausages;
• canned meat and fish;
• chocolate;
• ice cream, etc.

Gluten is found in some medicines, vitamins, nutritional supplements, lipstick, toothpaste - this must be taken into account when treating other diseases.

Before using any medicine, you should warn your doctor about your intolerance to cereal protein.

Allowed for use by children:

• cereals: rice, buckwheat, corn, millet;
• gluten-free flour;
• potatoes and other vegetables;
• fruits;
• eggs and dairy products;
• poultry, lean fish;
• jam, honey

Replacements for foods prohibited for celiac disease can be found in health food stores. Products that do not contain gluten have a special symbol on the packaging and are marked “gluten free”. Following a diet will require a high degree of responsibility from family members, because they will all have to reconsider their diet. The child himself must also know and understand the importance of following a diet.

A limited diet inevitably leads to a lack of vitamins and nutrients. That is why it is worth developing a nutrition plan together with a nutritionist so that it remains nutritious and gives the baby all the necessary substances for growth.

Enzyme therapy

A sick child needs to restore the functions of the liver and pancreas. For this, the gastroenterologist prescribes medications containing enzymes: Pancitrate, Creon, Pancreatin and Mezim. The doctor will build a treatment regimen and duration of treatment, the dosage will depend on the patient’s age.

Probiotics

Probiotics (Actimel, Linex, Bifiform, Hilak, Hilak-forte, Bifidumbacterin, Lactobacterin, Lacidofil) will help restore the intestinal microflora and remove toxic substances. They are taken in preventive courses as prescribed by a specialist and during periods of exacerbation of the disease. Probiotics can reduce the risk of complications of celiac disease and relieve unpleasant symptoms of the disease.

Vitamins

With celiac disease, there is a lack of vitamins and microelements, in particular: calcium, folic acid, iron, vitamin B12, vitamin D, vitamin K, zinc. If a sick child cannot take vitamins orally, they will be given by injection. When taking vitamins, you need to be sure that they do not contain gluten and carefully read the instructions.

Will folk remedies help?

Folk remedies for celiac disease are used only as a supplement to a gluten-free diet; if prohibited foods are consumed, they will not provide any benefit. They can be used to improve the condition of a small patient, but be sure to coordinate the appointment with the attending physician.

A herbal mixture of bedstraw, bifolia, meadowsweet, heather, speedwell, marsh grass and lungwort has a positive effect. With its help, during an exacerbation, the functioning of the pancreas is normalized.

Prognosis and possible complications of the disease

The prognosis of the disease is favorable provided that you follow a gluten-free diet and all the recommendations of a specialist. Children with this diagnosis are more susceptible to pneumococcal infections than others, so they are recommended to be vaccinated in accordance with the vaccination schedule.

In general, a constant diet has a beneficial effect on health, which in patients with celiac disease after restoration of the intestinal mucosa is even better than in other, “healthy” people who eat fast food and other junk food. The prognosis is unfavorable for those children who continue to consume foods containing gluten:

• the absorption of nutrients from food is impaired, a person does not receive enough vital vitamins and microelements, which inevitably leads to anemia, weight loss, and growth disorders;
• the child’s body does not receive enough calcium and vitamin D, the natural result is rickets and softening of bone tissue, osteoporosis;
• reproductive function suffers, there is a high probability of developing infertility;
• irritation of the small intestine leads to the fact that the child’s body ceases to absorb not only gluten, but also lactose, that is, all dairy products;
• an advanced form of celiac disease provokes neurological disorders and seizures;
• Constant inflammation and thinning of the intestinal mucosa can lead to certain types of cancer.

Hello, dear readers. Today we will talk about what treatment for celiac disease is. You will learn what this condition is, what symptoms indicate that your child has it, and why it occurs. You will also be able to find out what complications can arise in the absence of proper treatment, and by what methods this condition is diagnosed.

Classification

Celiac disease is a disease that is accompanied by a clear intolerance to gluten-containing foods. A negative reaction occurs due to the effect of this substance on the child’s intestines.

This pathology is mainly congenital in nature, often due to hereditary predisposition.

In such children, gluten that enters the intestines cannot be completely dissolved. Leads to the formation of toxic substances that negatively affect the walls of the intestinal mucosa. So the child may begin to vomit profusely, foamy stools will appear, and bloating will begin.

Based on how the disease progresses, there are several forms of celiac disease:

• typical - changes in the functioning of the organs of the digestive system are characteristic, intolerance to all dairy products is typical;
• atypical - there are no specific symptoms, the disease can be identified through diagnostic tests;
• hidden - has no manifestations;
• latent - is in a sleeping state.

Causes

To date, it is not completely known what exactly provokes the development of celiac disease in children. Researchers follow several directions in determining the root cause.

1. Immunological nature. Children with celiac disease are thought to have antibodies to gluten in their bodies. When this substance penetrates the intestines, lymphocytes begin to attack foreign objects, causing damage to its walls and mucous membrane.
2. Enzymatic theory. It is based on the fact that in the body of such babies there is no special enzyme in the small intestine that can break down gluten.
3. Viral. It is believed that in patients with celiac disease, antibodies to the adenovirus are found in the blood.
4. Pathoreceptor theory. It is based on the fact that such babies have disturbances in the structure of the walls of the intestinal mucosa, in particular pathology of the protein composition.

Most scientists are inclined to the immunological theory.

At-risk groups

Children with Down syndrome are more likely to develop celiac disease

There are a number of children who have a significantly higher risk of developing celiac disease than others. These include babies with:

• Down syndrome;
• autoimmune thyroiditis;
• Shereshevsky syndrome;
• family history of celiac disease;
• Williams syndrome;
• selective deficiency of immunoglobulin A;
• diabetes of the first type.

Characteristic signs

Weight loss is the first warning sign

Children in the first year of life may experience the following symptoms:

• presence of foamy, mushy stools;
• rickets;
• early ;
• slow growth;
• delayed teething.

Preschoolers are characterized by the presence of the following signs:

• diarrhea;
• flatulence;
• constipation;
• painful sensations in the abdomen;
• deterioration of appetite or its complete absence;
• underweight;
• growth retardation;
• moodiness, irritability.

Signs of celiac disease in schoolchildren:

• diarrhea or;
• bloating, increased accumulation of gases;
• feces are oily and float to the surface;
• obvious lack of body weight;
• lack of growth;
• thinning of bones;
• anemia.

Celiac disease in children photo:

Signs of celiac disease: 1 - severe thinness; 2- very bloated stomach

Manifestation on the skin:

• severe itching, burning;
• the appearance of bubbles filled with liquid;
• may occur on the buttocks, elbows, neck, knees, face;
• due to the fact that the child itches a lot, the blisters break down;
• the places where they burst are darkened;
• scars form.

Features of teeth in children with celiac disease:

• there is a change in the color of tooth enamel;
• formation of pits and grooves.

Features of the skeletal system:

• in such children, the bones are significantly weakened due to very poor absorption of vitamin D, as well as calcium;
• In this regard, the baby is much more prone to frequent fractures.

Diagnostics

In order to determine whether your baby has celiac disease, a personal examination of the child alone will not be enough. First, the doctor will collect a family history, find out complaints and send you for examination.

Diagnosis of celiac disease in children includes the following studies:

• general blood analysis;
• caprogram;
• if necessary, colonoscopy;
• biopsy of the intestinal mucosa;
• intestines;
• Venous blood test for celiac disease.

Possible complications

Thinning bones can lead to frequent fractures

If the disease is diagnosed late or the requirements of therapy and diet are not met, the risk of developing serious consequences will significantly increase.

• formation of ulcers in the small intestine;
• possible development of infertility;
• hypovitaminosis;
• retardation in mental and physical development;
• the risk of developing cancer of the digestive system is significantly increased;
• due to decreased bone density - frequent fractures, possible disability;
• Celiac disease (child one year or younger) in the absence of timely action can be fatal.

Treatment

In addition to following a gluten-free diet, your child may be prescribed medications.

1. In order to restore the normal composition of the intestinal microflora, Linex, Actimel or Hilak Forte are prescribed.
2. To reduce bloating - Espumisan or Plantex.
3. To improve the digestion process - Creon or Pancreatin.
4. If diarrhea is present, Smecta or Imodium will be prescribed.
5. To normalize the water-electrolyte balance - Panangin or Calcium Gluconate.
6. For vitamin deficiency, a multivitamin complex will be prescribed.
7. If the cause is autoimmune pathologies, glucocorticosteroids are prescribed.
8. If there is a serious lack of muscle mass, a high-calorie diet will be prescribed.
9. If the child has obvious protein deficiency, amino acids and albumin will be prescribed.

Diet features

1. It is unacceptable to consume products that contain barley, rye or wheat.
2. It is allowed to eat fresh vegetables, fruits, milk, fresh meat, corn, rice, potatoes, buckwheat.
3. You need to carefully study the labels on products; the manufacturer indicates the presence of gluten in them. Such food will be unacceptable for your baby.
4. Some children have problems eating foods containing lactose. If this happens to your baby, then it is better to give up such food for a while.
5. Please note that oats may be contaminated with wheat, so you should handle them with caution.
6. Please note the “gluten free” label.
7. If your child is diagnosed with celiac disease, be careful about everything he eats, monitor the reaction after eating each dish, and keep a food diary.

Now you know what celiac disease in children is and its symptoms. It is important to notice characteristic symptoms in time and contact your doctor for a referral for specific tests. Remember that it is important to diagnose celiac disease in time and start taking medications; in some cases, strict adherence to a gluten-free diet is sufficient.