Celiac Disease

Celiac disease is common in certain parts of Europe (especially Ireland). It occurs less frequently in the United States, affecting about one in 2,000 children in some areas. Over the past several years, the incidence of celiac disease has been on the decline.

In some patients, symptoms of celiac disease show up in late childhood or adolescence. In others, however, the problem appears in the first year of life, generally a couple of months after cereals are introduced.

WHAT CAUSES CELIAC DISEASE?
A number of factors seem to be involved. First, a genetic abnormality probably makes cerain children prone to celiac disease. For the disease to develop, however, the child must be exposed to foods containing gluten.

WHEN SHOULD I SUSPECT THAT MY CHILD HAS CELIAC DISEASE?
Babies and toddlers with celiac disease are irritable and they have poor appetites. They do not grow well and they develop chronic diarrhea with foul-smelling stools. The baby or child may have a bloated abdomen, shrunken buttocks and weak legs. Other possible signs include mouth sores, a smooth tongue, excessive bruising, and swelling of the arms and legs. Symptoms vary greatly, however. Instead of having diarrhea, some children may become constipated. Vomiting also occurs in some children. On the other hand, some children show no symptoms except decreased weight and short stature.

IS MEDICAL ATTENTION NECESSARY?
Yes. A number of conditions can cause symptoms similar to those of celiac disease, so a complete diagnostic workup is usually necessary. Cystic fibrosis may be confused with celiac disease.

HOW CAN THE PEDIATRICIAN TELL IF MY CHILD HAS CELIAC DISEASE?
The evaluation begins with laboratory analysis of blood and stool samples. If the doctor suspects celiac disease, the child may be placed on a gluten-free diet to see if symptoms disappear. If they do, the next step is to reintroduce gluten and see if symptoms reappear.

To get a definite diagnosis, a small sample of tissue must be removed from the intestinal lining and examined microscopically. This procedure can be performed using an endoscope, a thin, flexible tube inserted through the mouth and stomach to the upper part of the small intestine.

WHAT TREATMENTS ARE AVAILABLE?
Treatment consists of totally excluding wheat and rye from the diet. Most patients can eat oats, at least in small amounts. When the disease is first diagnosed, the child may have nutritional deficiencies that need to be corrected with vitamins, minerals or other supplements.

GETTING HELP
Call your doctor if your child:

• Has repeated bouts of diarrhea and vomiting

• Fails to gain weight

• Seems weak and listless

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.