Celiac disease is a genetically determined dysfunction of the small intestine, which is associated with a deficiency of gluten-breaking enzymes. Against the background of pathology, malabsorption develops, which has a different degree of severity and is accompanied by foamy diarrhea, as well as symptoms such as flatulence, weight loss, dry skin and a delay in the physical development of children.
In order to detect celiac disease, an immunological technique is used along with a small intestine biopsy. In case of confirmation of the diagnosis, a constant gluten-free diet is required, as well as the obligatory adjustment of the deficit of necessary substances and components. In our article, we will talk about celiac disease in children, consider what the symptoms are in this case and what treatment should be.
Description of the 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 as a result causes gluten intolerance. This is a protein found in cereals, for example, in wheat, rye, barley and so on. It contains the substance L-gliadin, which has a toxic effect on the mucosa and leads to disruption of the absorption of nutrients in the intestine. Most often, in eighty-five percent of cases, the complete exclusion of gluten from the diet causes a restoration of the functions of the small intestine after six months. Symptoms of celiac disease in children and a photo will be considered below.
Often children can be given a diagnosis that can scare parents and lead them into a stupor. Many children nowadays 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 violations of the intestinal wall in fifteen percent of family members of patients who suffer from this disease.
In addition, there is a dependence of the disease on immune status. In the body, an increase in titers of antibodies to the substance L-gliadin, as well as to tissue transglutaminase and a protein that is located in smooth muscle fibers, is noted. Signs of celiac disease in children are of interest to many.
The immune dependence of the disease is often confirmed by concomitant pathologies of an autoimmune nature, for example:
- The development of diabetes.
- The presence of connective tissue disease.
- The development of juvenile rheumatoid arthritis.
- The presence of autoimmune thyroiditis.
- The appearance of herpetiform dermatitis.
- The presence of Sjogren'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 can be poorly absorbed, against the background of which complete cleavage 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 of their own antibodies, contribute to a decrease in protective functions and lead to sensitivity to gliadin. In addition, the factors that contribute to the appearance 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 some viruses.
Reasons for the appearance
Celiac disease in children can occur as a result of heredity, as well as due to any other related factors that can trigger this pathology. The child is likely to inherit the risk of her occurrence from one or both parents at once. 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 allergies to wheat. Immediately allergic reactions can occur when various parts of the immune system react negatively to the elements that wheat contains. This causes the corresponding symptoms, for example, urticaria or bronchitis.
General symptoms
The difficulty is that the symptoms of celiac disease in children do not appear from birth, but much later. In breast-fed infants, symptoms may develop with the introduction of products containing gluten in the diet. Most often, they appear at the age of eight months, but in some cases the ailment can lurk inside the body for up to three years. Its manifestation can be recognized on the basis of the following signs:
- Underweight along with stunted growth.
- Irritability and moods.
- Change in stool, feces becomes porridge and foamy.
- The presence of abdominal pain.
- The development of rickets.
- Teething delay.
- Intolerance to cow's milk protein .
Symptoms of celiac disease in children under one year
Young children from their birth to a year may experience the following symptoms:
- Changes in the consistency, as well as in the appearance of feces. In this case, the stool acquires a porridge and foamy stool.
- 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 bending the bones.
- Late teething 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:
- The presence of diarrhea or constipation.
- The appearance of vomiting. It does not always happen, sometimes there is constant nausea.
- Bloating.
- The appearance of abdominal pain of varying degrees of intensity.
- The presence of poor appetite.
- Noticeable lag in height and weight. These children, as a rule, have difficulty in gaining weight.
- Excessive irritability and moodiness.
All of these symptoms can occur at any age immediately after the child begins to eat gluten-containing foods in his diet. This can happen, starting from infancy and ending with the onset of adulthood. In some situations, the child may not feel any of the common symptoms, but at the same time he will experience various problems associated with slow growth, iron deficiency anemia, a rash on the skin or serious problems with the teeth.
Photos of children with celiac disease are presented in the article.
Symptoms among older children
In children who are already at an older age, the symptoms may be as follows:
- Frequent constipation or diarrhea. However, they can alternate.
- The presence of oily feces floating on the surface.
- Bloating.
- Growth in a child with celiac disease usually lags noticeably compared to peers.
- The development of anemia along with thinning of bones.
Symptoms of celiac disease in children may vary. As a rule, they appear very individually in each case.
Forms of celiac disease
What types of this disease? In clinical gastroenterology, specialists distinguish three forms of the course of celiac disease:
- A typical form develops in the first year of a child’s life and is characterized by characteristic clinical manifestations.
- The erased form manifests itself by extraintestinal symptoms in the form of iron deficiency, anemia, bleeding and osteoporosis.
- The latent form most often passes without expressed complaints.
Diagnosis of the disease in children
Until now, the diagnosis of celiac disease in children (pictured) does not have a clear algorithm. The diagnosis is usually determined on the basis of the following studies:
- Taking a blood test from a child.
- Clinical manifestations.
- The results of the coprogram, in the framework of which the feces are analyzed.
- Colonoscopy results. As part of this procedure, an examination of the intestinal wall is performed through a special chamber.
- A 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 discovered, the faster the doctors together with their 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, treatment of the infant 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 certainly 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 diet of the child 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. Diet for celiac disease in children implies a ban on the following types of products:
- Any products, 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 yogurt.
- Dishes based on semi-finished meat products or sausages.
- Various sauces and canned food.
- Whole milk is also considered undesirable for the baby.
Among the permitted foods are the following:
- Potatoes, rice, buckwheat porridge and soy.
- Fish dishes along with corn and cottage cheese.
- Fruits and vegetables.
- Legumes.
- Dishes based on lean meat and vegetable oil.
Proper baby food against the background of celiac disease is a prerequisite for the health of a child who suffers from this disease.
Carrying out enzyme therapy for celiac disease
During an exacerbation of the disease, children are prescribed enzyme therapy to facilitate the functioning 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 such drugs as Pancytrate, Pancreatin, and Mezim.
Treatment of pathology with probiotics
Probiotics are drugs designed to restore normal microflora in the intestines. These drugs include “Hilak-forte”, “Bifidumbacterin”, “Latsidofil” and other drugs. Prescribe such medicines to children usually as preventive courses, as well as during periods of exacerbation.
Vitamin Therapy
When a child is one year old, celiac disease should be treated with vitamins. This is required to fill the lack of trace elements, the absorption of which due to the development of pathology is significantly impaired. 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.
Disease prevention
As such, the primary specific prevention of the described disease does not exist. Directly secondary prevention of the development of clinical symptoms consists, as already noted, in following a gluten-free diet. If celiac disease is present in the immediate family of the child, it is recommended that a periodic examination of the child's body be made to determine specific antibodies.
Pregnant women who suffer from pathology automatically fall into the risk group regarding the development of heart disease in the fetus. Pregnancy management in such patients should be carried out with increased attention.
Clinical 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 necessarily observe gluten-free nutrition throughout their lives. Careful adherence to it contributes to maintaining the quality of life and increasing its duration. In case of non-compliance with the diet, the survival rate of such patients drops sharply. Cases of deaths of people who violate the gluten-free diet, up to thirty percent. It should be emphasized that, subject to strict adherence to the diet, this indicator, as a rule, does not exceed one percent.
All children who suffer from celiac disease should be required to be registered with gastroenterologists and undergo annual examinations. For patients who are poorly responsive to the exclusion of gluten from the diet, clinical examination is prescribed 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, for example, diarrhea, weight loss along with bloating, pain in the stomach or lack of appetite. This symptomatology occurs because the child’s immunity does not respond correctly to the protein found in certain foods. In addition to the main treatment, the most important measure should be the child's observance of the required gluten-free diet.