Childhood Celiac Disease

Childhood Celiac Disease

Celiac disease, also known as gluten-sensitive enteropathy is a condition where a person's immune system makes antibodies to gluten (Mahan & Escott-Stump, 2008). It is an inherited disease and many cases remain undiagnosed because symptoms mimic many other gastrointestinal conditions. Only about three percent of people who have celiac disease have been diagnosed. Celiac disease is a systemic autoimmune disorder that is most commonly associated with gastrointestinal symptoms, including diarrhea, weight loss, anorexia, lactose intolerance, and abdominal distention and discomfort.

It is difficult to say that a patient's history is typical of a person who has celiac disease because patients are sometimes asymptomatic and symptoms vary greatly from person to person (Celiac Sprue Association, 2008). Some symptoms frequently mentioned in a patient's history include flatulence, diarrhea, steatorrhea, abdominal pain, anemia and weight loss (Celiac Disease Foundation, 2011). There are a multitude of symptoms that a patient may mention but some are fairly common. In general, notes include that patients complained of severe, foul-smelling diarrhea, the patients had a family history (mother and grandmother) of diarrhea, and difficulty maintaining body weight (Nelms, 2009). The presence of non-gastrointestinal characteristics are highly variable but include: chronic fatigue, joint pain/inflammation, migraines, epilepsy, depression, attention deficit disorder, irondeficiency anemia, vitamin deficiency, osteoporosis/osteopenia, short stature, delayed puberty, dental enamel defects, infertility, recurrent fetal loss, and dermatitis herpetiformis.

Celiac disease is a genetic condition and many patients will mention that someone in their family has been diagnosed or suffers from symptoms similar to their own. (Celiac Disease Foundation, 2011). According to the Celiac Disease Foundation (2011), if a person has a family member who has a diagnosis of celiac disease they have a one in four chance of also having celiac disease. Although patients mostly do not have a family member who has been diagnosed but if a lot of female cases the mother and grandmother both have frequent diarrhea (Nelms, 2009). It is likely that they are suffering from celiac disease as well. Most commonly, affected individuals have no gastrointestinal symptoms (non-classic disease). The diagnosis is based on the following; The classic histological findings from small bowel biopsy and the histologic or clinical improvement after adherence to a gluten-free diet.

Patients with celiac disease must be on the lookout for hidden gluten. Gluten is a protein found in the wheat, rye and barley. These grains each contain a different peptide that presents a problem for patients with celiac disease. The peptide culprits in barley are hordeins, in rye, secalinus and in wheat, glutenins and gliadins (Mahan & Escott-Stump, 2008). In addition, gluten can be found in grains related to wheat, rye and barley (such as farro and spelt). Hidden food sources of gluten include modified food starch, textured vegetable protein and flavorings (Mahan & Escott-Stump, 2008). Gluten may be used as an additive in medications and is often used in lipstick and even play dough. In addition, gluten is commonly found in vitamin/mineral supplements and in herbal supplements (NIDDK, 2008). The glue on envelopes and stamps ...