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Coeliac disease

by Dr Kerry Robinson
First described by a Roman physician in 250AD, coeliac disease affects 1 in 1500 people in the UK. Dr Kerry Robinson describes the diagnosis and treatment for children

Parents often encounter coeliac disease for the first time when they start to wean their baby off milk onto solids. Some babies react to foods containing gluten – a substance found in wheat, rye, oats and barley. Proteins containing gluten trigger an immune reaction that damages the delicate lining of the intestine and causes serious problems with digestion. Diarrhoea or bulky stools are the main symptoms, but babies with coeliac disease can’t absorb essential vitamins and minerals from foods if they contain gluten and so in the long term both their growth and development can be affected.

What happens in the intestine?

The lining of the intestine is usually full of leaf-like folds called villi. These villi are richly coated with digestive enzymes. If a child with the coeliac genetic make up eats gluten, the villi get destroyed. This also destroys the digestive enzymes and, as a result, the intestines can no longer digest food properly.

Other signs and symptoms

If a child with coeliac disease eats foods containing gluten, they can’t absorb vital vitamins and minerals, so stored sources of body energy get used instead. As a result, the child becomes very thin with flat buttocks and a bloated tummy. They can become listless and tired and may also be small for their age. They can also suffer calcium deficiency, which affects the development and structure of their bones.

We don’t know why some people develop this immune reaction and some don’t

We do know that coeliac disease runs in families. Close relatives of someone with coeliac disease have a five to10% chance of developing the problem themselves and it doesn’t always start in childhood. In fact most cases of coeliac disease are diagnosed in adults between the ages of 30 and 45.

Exclude gluten from the diet and the symptoms disappear

This can take some time and has to be a lifelong commitment but the effect is dramatic. Wheat starch can be specially manufactured to remove the gluten component and in the UK certain gluten products (including bread) are available on prescription from the chemist. You should check this with your GP.

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