Celiac disease is a genetically determined disorder of the function of the small intestine, which is associated with a deficiency of enzymes that break down gluten. Against the background of pathology, malabsorption develops, which has varying degrees of severity and is accompanied by foamy diarrhea, as well as symptoms such as flatulence, weight loss, dry skin and delayed physical development of children.
In order to detect celiac disease, an immunological technique is used along with a biopsy of the small intestine. If the diagnosis is confirmed, a constant adherence to a gluten-free diet is required, as well as a mandatory correction of the deficiency of essential substances and components. In our article we will talk about celiac disease in children, consider what the symptoms are in this case and what should be the treatment.
Description of disease
Celiac disease is a disease characterized by chronic inflammation of the intestinal mucosa, which is accompanied by a violation of the absorption process, which results ingluten intolerance. It is a protein found in cereals such as wheat, rye, barley, and so on. It contains the substance L-gliadin, which has a toxic effect on the mucous membrane and leads to disruption of the absorption of nutrients in the intestine. Most often, in eighty-five percent of cases, the complete elimination of gluten from the diet causes the restoration of the functions of the small intestine after six months. Symptoms of celiac disease in children and photos will be discussed below.
It is not uncommon for children to be given a diagnosis that can frighten their parents and lead them into a stupor. Many children today suffer from this chronic disease characterized by congenital or acquired gluten intolerance.
Etiology and pathogenesis
Celiac disease in children has a genetic predisposition. This is confirmed by disorders of the intestinal wall in fifteen percent of the family members of patients who suffer from this disease.
In addition, there is a dependence of the disease on the immune status. In the body, there is an increase in antibody titers to the substance L-gliadin, as well as to tissue transglutaminase and a protein found in smooth muscle fibers. Signs of celiac disease in children are of interest to many.
The immune dependence of the disease is often confirmed by comorbidities that are autoimmune in nature, for example:
- Development of diabetes.
- Presence of connective tissue disease.
- Development of juvenile rheumatoidarthritis.
- Presence of autoimmune thyroiditis.
- Appearance of dermatitis herpetiformis.
- Presence of Sjögren's syndrome.
Some congenital, as well as acquired features of the intestine can contribute to the sensitivity of epithelial cells to gliadin. Enzyme deficiency should be attributed to such conditions, as a result of which peptides may be poorly absorbed, against which the complete breakdown of gliadin will not occur. A large amount of gliadin accumulated in the intestine can contribute to the manifestation of toxic effects.
Autoimmune disorders in situations where epithelial cells are the target for self-antibodies contribute to a decrease in protective functions and lead to sensitivity to gliadin. In addition, factors that contribute to the emergence of gliadin intolerance are genetically determined characteristics of the cell membranes of the intestinal epithelium, along with the result of changes in the receptor apparatus due to certain viruses.
Reasons for appearance
Celiac disease in children may appear as a result of heredity, as well as due to any other concomitant factors that can trigger this pathology. The child most likely inherits the risk of it from one or both parents. As a rule, this disease does not manifest itself immediately, but only as a result of eating foods that contain a large amount of gluten.
Celiac disease is significantly different from wheat allergy. Direct allergic reactions may occurwhen various parts of the immune system react negatively to the elements that wheat contains in its composition. This causes the corresponding symptoms, such as hives or bronchitis.
General symptoms
The difficulty lies in the fact that the symptoms of celiac disease in children do not appear from birth, but much later. Breastfed babies may develop symptoms with the introduction of foods containing gluten into the diet. Most often they appear at the age of eight months, but in some cases the disease can lurk inside the body for up to three years. You can recognize its manifestation based on the following signs:
- Being underweight along with stunted growth.
- Irritability and whims.
- Change in stool, feces become mushy and frothy.
- Presence of abdominal pain.
- Development of rickets.
- Delayed teething.
- Cow's milk protein intolerance.
Symptoms of celiac disease in children under one year old
Young children from birth to one year of age may experience the following symptoms:
- Changes in the consistency and also in the appearance of the feces. In this case, the feces become mushy and frothy stools.
- Bloating, intestinal colic.
- Constant regurgitation. Most often, this symptom is observed among newborns.
- Light weight along with slow growth.
- The development of rickets, that is, the appearance of the process of curvature of the bones.
- Late teethingteeth along with early caries.
Consider also the symptoms of celiac disease in preschool children.
Symptoms in preschoolers
Children in preschool age may experience the following symptoms of this disease:
- Presence of diarrhea or constipation.
- The appearance of vomiting. Not always, sometimes there is constant nausea.
- Bloating.
- The appearance of pain in the abdomen of varying degrees of intensity.
- Presence of poor appetite.
- Noticeable lag in height and weight. These children tend to have difficulty gaining weight.
- Excessive irritability and moodiness.
All of these symptoms can appear at any age as soon as a child starts eating gluten-containing foods in their diet. This can happen from infancy to adulthood. In some situations, the child may not experience any of the common symptoms, but they will have various problems associated with stunted growth, iron deficiency anemia, skin rashes, or severe dental problems.
Photos of children with celiac disease are presented in the article.
Symptoms in older children
In older children, symptoms may include:
- Frequent constipation or diarrhea. However, they can alternate.
- Presence of oily stools floating onsurface.
- Bloating.
- Children with celiac disease usually lag behind their peers in height.
- Development of anemia along with bone thinning.
Symptoms of celiac disease in children can vary. As a rule, they appear very individually in each case.
Forms of celiac disease
What are the types of this disease? In clinical gastroenterology, specialists distinguish three forms of celiac disease:
- Typical form, develops in the first year of a child's life and is characterized by characteristic clinical manifestations.
- The erased form manifests itself as extraintestinal symptoms in the form of iron deficiency, anemia, bleeding and osteoporosis.
- Latent form most often passes without expressed complaints.
Diagnosis of disease in children
Until now, diagnosing celiac disease in children (pictured) does not have a clear algorithm. The diagnosis is determined, as a rule, on the basis of the following studies:
- Taking a blood test from a child.
- Clinical manifestations.
- Results of the coprogram, in which stool analysis is performed.
- Colonoscopy results. As part of this procedure, an examination of the intestinal wall is performed using a special camera.
- Biopsy of the intestinal mucosa.
- X-ray examination of the intestine.
- Ultrasound examination of the abdominal cavity.
Diagnosis of celiac disease in children should be timely.
The earlier the pathology was detected, the sooner the doctors together with the parents will be able to alleviate the condition of the sick child. Proper and timely treatment makes it possible to return the baby to a full-fledged lifestyle.
Treatment of celiac disease in children
As a rule, the treatment of the childhood form of the disease involves several directions. At the same time, one of them is considered the most decisive and important, without which there will definitely not be a full recovery. This is a special diet that excludes foods that contain gluten.
How should children with celiac disease eat?
Diet therapy for this pathology
A gluten-free diet is a fundamental aspect in the treatment of this disease. The complete exclusion of gluten from the child's diet is guaranteed to eliminate its destructive effect on the walls of the young intestine. As a result, the symptoms of the disease will completely disappear. The diet for celiac disease in children involves the prohibition of the following types of foods:
- Any food, as well as dishes with the addition of oats, rye, barley or wheat.
- Pasta or bakery products along with cookies, cakes, pastries and so on.
- Ice cream and yoghurts.
- Dishes based on semi-finished meat or sausages.
- Various sauces and preserves.
- Whole milk is also considered undesirable for a baby.
Among the allowed foods are the following:
- Potatoes, rice, buckwheat and soybeans.
- Fish dishes along with corn and cottage cheese.
- Fruit andvegetables.
- Beans.
- Dishes based on lean meat and vegetable oil.
Proper baby food against the background of celiac disease is an essential guarantee of the he alth of a child who suffers from this disease.
Enzyme therapy for celiac disease
Children during an exacerbation of the disease are prescribed enzyme therapy to facilitate the work and normal functioning of the pancreas and liver. The drugs, along with the treatment regimen and the duration of the course, should be selected by a gastroenterologist. Most often, doctors prescribe drugs such as Pancitrate, Pancreatin and Mezim.
Treatment of pathology with probiotics
Probiotics are drugs designed to restore the normal microflora in the intestines. Such medicines include Hilak-forte, Bifidumbacterin, Lacidophil and other drugs. Such medications are usually prescribed for children as preventive courses, as well as during periods of exacerbations.
Vitamin therapy
When a child is a year old, celiac disease should be treated with vitamins. This is required to compensate for the lack of trace elements, the absorption of which is significantly impaired due to the development of pathology. It is extremely important for children to use multivitamin complexes, which should be selected exclusively by a doctor.
Children's celiac disease is far from the most dangerous disease, but it still requires constant and strict adherence to a diet that will allow the child to live a full life.
Preventiondiseases
As such, there is no primary specific prevention of the described disease. Directly secondary prevention of the development of clinical symptoms consists, as already noted, in observing a gluten-free diet. If the child's immediate family has celiac disease, it is recommended to conduct a periodic examination of the child's body in order to establish specific antibodies.
Pregnant women who suffer from pathology automatically fall into the risk group for the development of heart disease in the fetus. The management of pregnancy in such patients should be carried out with increased attention.
Medical examination and prognosis for this disease
Correction of the sensitivity of epithelial cells to a substance such as gluten is currently not possible, for this reason, children with celiac disease must follow a gluten-free diet throughout their lives. Careful observance of it helps to preserve the quality of life and increase its duration. In case of non-compliance with the diet, the survival rate of such patients drops sharply. The death rate of people who violate a gluten-free diet is up to thirty percent. It should be emphasized that, subject to strict adherence to the diet, this figure, as a rule, does not exceed one percent.
All children who suffer from celiac disease must be registered with gastroenterologists and undergo annual examinations. For patients who are poorly responsive to the exclusion of gluten from the diet, clinical examinationappointed twice a year. The prognosis of the pathology can noticeably worsen if this disease is complicated by the occurrence of intestinal lymphoma.
Thus, celiac disease in children is a disease that can cause various symptoms, such as diarrhea, weight loss along with bloating, stomach pain or lack of appetite. This symptomatology occurs because the child's immunity reacts incorrectly to the protein that is contained in certain foods. Apart from basic treatment, the most important measure should be that the child is on the required gluten-free diet.
