Schoolage Children: Gluten Allergy (Celiac Disease)
Celiac disease (CD) is a lifelong autoimmune disorder that affects the intestines. Celiac disease is considered a multi-system and multi-symptom disorder that manifests itself in a variety of symptoms that are similar to other bowel disorders. Celiac disease symptoms are triggered by the gluten protein found in certain foods, and is thus often referred to as a gluten allergy.
What is Celiac Disease (Gluten Allergy)?
When an individual with celiac disease ingests gluten, an immunologically toxic reaction takes place within the body. This gluten allergy reaction causes damage to the surface of the small intestine - in particular, the tiny hair-like structures (villi) responsible for the absorption of food nutrients. This in turn interferes with the bodyï¿½s ability to absorb nutrients such as carbohydrates, proteins, fats, vitamins, minerals, water and bile salts.
Gluten allergy symptoms can lead to an increased risk of developing certain disorders such as nutritional and immune-related disorders which can be chronic or life threatening. A person may develop celiac disease at any age.
What Causes Celiac Disease (Gluten Allergy)?
The cause of a gluten allergy or celiac disease is not well understood; however, researchers have found a potential relationship between a gluten allergy and a group of genes that are responsible for the bodyï¿½s immune response to gluten. For this reason, a gluten allergy is believed to affect individuals who are genetically prone to it. In particular, an individual who has a twin with a gluten allergy is 70% more likely to develop celiac disease.
Individuals who have an autoimmune disease are at an increased risk of developing celiac disease. The following conditions are associated with a gluten allergy:
- type 1 diabetes
- thyroid problems
- ulcerative colitis
In addition, celiac disease may be triggered by surgery, a viral infection or emotional stress.
Gluten Allergy Symptoms
In children, the following gluten allergy symptoms are associated with celiac disease. Gluten allergy symptoms will not begin to appear in toddlers until foods containing gluten are introduced into the diet:
- decreased appetite
- behavioral changes
- inability to gain weight
- pale, bulky stools
- swollen stomach
- thin arm and leg muscles
- growth failure
Other gluten allergy symptoms can include abdominal cramping, intestinal gas, diarrhea, constipation, skin rash, mouth ulcers, fatigue and anemia.
Diagnosing Gluten Allergy
Diagnosing gluten allergy or celiac disease will typically involve blood tests following consultation with a doctor who will ask questions regarding gluten allergy symptoms. A doctor will also examine the abdomen.
Blood tests for diagnosing gluten allergy will typically check for signs of anemia including iron, folic acid and calcium levels in the blood. Another blood test will assess the presence of certain antibodies associated with celiac disease.
If high levels of gluten allergy antibodies are found, a biopsy of the small intestine may be performed. This will involve the insertion of a thin tube (endoscope) through the mouth in order to reach the stomach and intestine. A child will usually be sedated or put under general anesthesia during this process.
Gluten Allergy Treatment
The only treatment available for celiac disease is to avoid foods that contain gluten. Gluten is the protein found in wheat, rye, barley and other related grains. The following ingredients should be avoided in order to maintain a gluten-free diet:
- udon (noodles)
- graham powder
- caramel color
- unidentified and modified food starch
- hydrolyzed proteins
In general, the following foods containing gluten should be avoided:
- breaded foods (such as chicken)
- breakfast cereals
- brown rich syrup
- cakes, biscuits and pastries
- marinades and salad dressings
- processed and imitation meats
- canned soups
- certain teas
- cheese spreads or soft cheeses
- yogurt with wheat starch
- malt vinegar, sot sauce, mustard and mayonnaise
- certain candies
Many foods contain hidden gluten ingredients. It may also be necessary to replace certain vitamins and minerals, such as iron, through supplements. In severe cases of celiac disease, steroids that help strengthen the immune system may be recommended.
There are many gluten-free alternatives available at select grocery stores and pharmacies. In addition, a doctor may be able to prescribe foods such as gluten-free flour, breads, biscuits and pasta.
The following natural food sources do not contain gluten and can be incorporated into a healthy gluten-free diet:
- all fruits and vegetables
- rice and corn
- red meat
In addition, oats are generally safe to eat for people with celiac disease since they contain a small amount of gluten; however, oats are often processed and stored with wheat and may need to be avoided. Sunflower and olive oil are best for cooking.
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