Celiac disease in children: symptoms and treatment
Celiac disease in children is a hereditary disease that affects the intestinal mucosa due to intolerance to gluten, which is abundant in cereals. Often, this ailment develops in children from the age of two, signs are expressed weakly, but as the disease progresses, they become more vivid. In some cases, the first symptoms can be seen in an infant who has intolerance to cow’s milk. After excluding from the diet products containing gluten protein, the condition improves and comes back to normal within a year.
There are no exact reasons for the progression of this disease in children, but it is believed that predisposing factors are genetic predisposition, autoimmune diseases that have a negative effect on the intestinal mucosa, some varieties of viral infections. The main manifestations of such a syndrome are: lack of appetite and weight loss, liquid and foamy feces, increased stomach volume, stunting and sexual development.
Diagnosis of the disease is based on laboratory studies of feces and blood, intestinal biopsy and instrumental examinations of the child. Treatment of such a syndrome is based on adherence to a special diet, taking a vitamin complex and enzymes to improve the digestive system. Without timely therapy, the disease can cause disability or death of the child.
The main cause of the syndrome of gluten intolerance is in genetic disorders that create favorable conditions for damage to the structure of the intestinal mucosa in the use of certain cereals. There are several favorable factors contributing to the development of the disease:
- the presence of a similar disorder in close relatives
- Down Syndrome
- autoimmune diseases of the thyroid or pancreas, against which there is an attack of the immune system of one’s own cells
- inflammatory process in the intestines, because of which in the cells of this organ, accumulation of lymphocytes occurs
- a wide range of intestinal infections
- chronic hepatitis
- prolonged impact on the child of stressful situations;
- Complications after surgery, for example, after removal of appendicitis.
However, the exact causes of the disease in children are not fully known.
In modern medicine, there are several forms of celiac disease in children:
- typical — there are abnormalities in the functioning of the gastrointestinal tract and intolerance of any dairy products
- atypical — the symptoms of the disease may not manifest at all;
- hidden — in most cases occurs without expressing any characteristics;
- latent — manifestations of the disease are completely absent. Diagnosis is carried out with the help of blood and feces analysis;
- refractory — accompanied by pronounced symptoms. It differs from other forms in that, if the diet is observed, there is no improvement in the child’s condition. This causes disability or death.
The primary manifestation of the syndrome is not expressed immediately. In infants, signs begin to occur when introducing complementary foods, when gluten-containing foods are added to the diet. The symptoms of the disease become more pronounced in babies for up to a year — starting from eight months. In some children, characteristic features occur closer to three years.
Signs of this disorder in children under two years of age:
- liquid stool with the content of particles of fat, foam. Often have a persistent unpleasant odor;
- increased abdominal volume
- nausea accompanied by vomiting
- lag in growth and weight gain from healthy peers
- constant tearfulness and excitement of the child
- delay in psychomotor development — children later start to keep their heads on their own, show interest in new toys and people, crawl and walk.
Symptoms of a disease in children older than two years and adolescents:
- diarrhea followed by constipation
- pallor of the skin;
- increased fatigue;
- Delay in puberty. In girls, menstruation can begin by fifteen years or later. There is insufficient development of mammary glands
- lag in growth — in girls it does not exceed 155 cm, in young people — 165 cm
- allergic reactions — the appearance on the skin of a characteristic rash
- Osteoporosis — a decrease in bone density is observed. It occurs in half of children with a diagnosis of celiac disease. After the elimination of cereals, restoration of bone density is observed. The entire process takes no more than one year. In some cases, it can become a factor of disability;
- increased hair loss.
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:
- Preservation of the symptoms of this disorder even when all the rules regarding nutrition are fulfilled;
- formation of small intestine ulcers
- infertility — observed with a severe course of the disease
- Vitamin deficiency in the body
- significant mental and mental retardation in development
- increase the likelihood of oncology of the gastrointestinal tract
- frequent bone fractures or disabilities — against a background of decreased bone density
- fatal outcome — with rapid development and severe celiac disease in children less than 2 years of age
If you follow a gluten-free diet throughout life, many of the above effects can be avoided.
The primary diagnosis is established by the specialist on the basis of examination of the patient, elucidation of possible causes of the formation of diseases, the presence and intensity of certain symptoms. The examination includes measurement of growth and body weight, palpation of the abdomen. The main value in the diagnosis of celiac disease in children are laboratory tests:
- blood — general and biochemical
- microscopic and bacteriological study of stools
- genetic tests.
Instrumental methods for confirming the diagnosis include — an intestinal biopsy, during which a small portion of the mucosa is sampled for subsequent detailed examination. FGDS — enables the specialist to examine and assess the structural state of the gastrointestinal tract. Ultrasound of the abdominal organs — to find and confirm the presence of intestinal damage, digestive disorders. Densitometry — allows you to determine the density of bone tissue.
In addition, it is necessary to consult an allergist-immunologist. Some specialists during the diagnosis ask for a few days not to give the child products containing gluten, then repeat some tests and assess the overall condition of the patient. When the indicators are changed for the better, the diagnosis of «celiac disease» is established with accuracy.
Treatment of celiac disease in children necessarily involves a lifetime rejection of cereals 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 necessary to limit the use of sausages, smoked products, ice cream, chocolate, various sauces, ketchups and mayonnaises, coffee and cocoa, canned food. This is due to the fact that they can also contain this protein. It is allowed to take products made from rice and corn flour, as well as potatoes, fish, meat and fruits. With proper nutrition, the first improvement is visible after a month — a full recovery of the intestinal mucosa occurs throughout the year.
In addition, the treatment of this syndrome is aimed at eliminating symptoms not related to the gastrointestinal tract. Often, patients are prescribed:
- drugs to increase hemoglobin levels;
- medicines containing calcium and vitamin D — necessary to strengthen bone tissue. Normalization of bone density is achieved about a year later. Otherwise, increased brittleness of the bones can lead to disability;
- Vitamin Complexes.
If necessary, prescribe courses of therapy for the therapist. With timely and correct treatment, the prognosis of the disease is favorable.
Specific prevention of celiac disease in children does not exist, it is necessary only to maintain a diet throughout life, and in the future to abandon harmful habits — the use of alcohol and tobacco. To confirm the hereditary factor and the presence of predisposing factors, it is necessary to undergo regular examinations with specialists — at least twice a year. If the first signs of the syndrome occur, immediately go to a medical facility. The sooner the treatment begins, the higher the probability of complete recovery and the absence of undesirable consequences, including disability and death.