Relatively recently, a number of studies have been conducted on the atypical form of celiac disease in children.

Research results:

• It is noticed that the atypical form of celiac disease is more common in older children. Less common in children over 5 years of age.

• It is noticed that girls suffer from celiac disease more often than boys.
• A close relationship of atypical celiac disease with damage to the hypothalamic-pituitary system, which is responsible for the proper joint work of the nervous and endocrine systems, has been proven. Disturbances in the work of the pituitary and hypothalamus lead to damage to the adrenal glands, underweight, thyroid diseases.
• A link between celiac disease and diseases such as type 1 diabetes and autoimmune thyroiditis has been proven. If a child is diagnosed with one of the above diseases, the probability of having the other two is extremely high.
• A link has been established between celiac disease and various diseases of the upper gastrointestinal tract. Many children whose examination consisted only in identifying diseases of the gastrointestinal tract were later diagnosed with an atypical form of celiac disease.
• The results of the studies also made it possible to identify three groups of symptoms of atypical celiac disease in children.

Symptoms of atypical celiac disease in children

The most common symptoms of atypical celiac disease in children are:

• growth retardation;
• low weight;
• neurological disorders;
• delayed sexual development;
• atopic dermatitis;
• anemia;
• alopecia;
• thinned mucosa of the small intestine.

Children with atypical celiac disease may occasionally have intestinal and extraintestinal symptoms of typical celiac disease. However, in the atypical form of celiac disease, they are less pronounced.

This group of symptoms includes:

• intermittent diarrhea (periodic);
• recurrent abdominal pain;
• weakness and fatigue;
• osteoporosis;
• aphthous stomatitis.

The third group of symptoms of atypical celiac disease includes symptoms that are more often observed in the latent (hidden) form of celiac disease:

• diseases of the gastrointestinal tract (gastritis, gastroduodenitis, etc.);
• bronchial asthma;
• hives;
• psoriasis;
• vetiligo;
• obesity;
• chronic viral infections.

Diagnosis of atypical celiac disease in children

The main part of the diet in a gluten-free diet should be occupied by vegetables, fruits, cereals and cereals (derived from cereals that do not contain gluten), meat, eggs, vegetable fats and prepared foods that do not contain gluten (gluten-free bakery products, pastries without gluten-free, gluten-free pasta, gluten-free sausages and frankfurters, gluten-free sauces and condiments, gluten-free pâtés, etc.)

In most cases, children with atypical celiac disease need to stop eating dairy products along with foods containing gluten. The reason is lactose or casein intolerance, developing due to celiac disease or as an independent disease. Symptoms of intolerance to dairy products are flatulence, sharp pains in the abdomen, diarrhea, skin rash.

With strict adherence to a gluten-free diet, the health of children suffering from an atypical form of celiac disease begins to recover in 2-3 weeks.

In the treatment of an advanced form of celiac disease, the recovery process of the body may take longer.

In addition, the duration of recovery of health depends on the presence of diseases and complications caused by celiac disease in the child. As a rule, they take much longer to eliminate than to eliminate the symptoms of atypical celiac disease.

In the treatment of atypical celiac disease, along with a gluten-free diet, rehabilitation therapy is mandatory - vitamin therapy, courses of enzyme preparations, courses of probiotics and other rehabilitation measures.

Prediction of the course of an atypical form of celiac disease in children

Severe and very severe prognosis is possible when diagnosing a very advanced stage of celiac disease.

Therefore, early diagnosis of celiac disease is important to avoid the development of complications.

With timely diagnosis of celiac disease and the appointment of appropriate treatment, the prognosis is good.

In most cases, adherence to a gluten-free diet leads to the elimination of symptoms of celiac disease and the restoration of intestinal mucosa and absorption function.

The main condition for a favorable prognosis is lifelong adherence to a gluten-free diet (products gluten free).

IMPORTANT. Violation of the diet leads to the resumption and progression of the disease, increases the risk of complications.

Desserts without gluten. Puffed rice with powdered sugar, roasted nuts or seeds, orange jelly, grapefruit jelly and persimmon jelly

Celiac disease is a genetic disorder of the small intestine that 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 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, resulting in gluten 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.

Often, children can be given a diagnosis that can scare 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:

• The development of diabetes.
• The presence of connective tissue disease.
• development of juvenile rheumatoid arthritis.
• Presence of autoimmune thyroiditis.
• The appearance of dermatitis herpetiformis.
• The 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. Such conditions should be attributed as a result of which peptides may be poorly absorbed, against the background of which there will be no complete cleavage of gliadin. 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 the appearance

Celiac disease in children can 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. Directly allergic reactions can occur when 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. Its manifestation can be recognized on the basis of the following signs:

• Weight loss along with slow growth.
• Irritability and whims.
• Change in stool, feces become mushy and frothy.
• The presence of pain in the abdomen.
• development of rickets.
• Delay in teething.
• cow's milk.

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, as well as in the appearance of feces. In this case, the stool acquires a mushy and foamy stool.
• Bloating, intestinal colic.
• Constant vomiting. 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 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:

• Presence of diarrhea or constipation.
• The appearance of vomiting. It does not always happen, sometimes there is constant nausea.
• Bloating.
• The appearance of pain in the abdomen of varying degrees of intensity.
• The presence of poor appetite.
• Noticeable lag in height and weight. These children usually have difficulty gaining weight.
• Excessive irritability and capriciousness.

All of these symptoms can appear at any age immediately after the child begins to consume food containing gluten in his diet. This can happen from infancy to adulthood. In some situations, the child may not experience any of the common symptoms, but they will experience various problems associated with stunted growth, iron deficiency anemia, skin rashes, or serious 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 on the surface.
• Bloating.
• The height of a child with celiac disease is usually markedly behind compared to peers.
• The development of anemia along with thinning of the bones.

The 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:

• A typical form develops in the first year of a child's life and is distinguished by characteristic clinical manifestations.
• The erased form manifests itself as 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, diagnosing 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 which the analysis of feces is carried out.
• 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 faster 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 provides for 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. We are talking about 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 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 or sausages.
• Various sauces and preserves.
• Whole milk is also considered undesirable for a 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.
• Bean cultures.
• Dishes based on lean meat and vegetable oil.

Proper baby food against the background of celiac disease is an essential guarantee of the health 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. Prescribe such medications for children, usually as preventive courses, as well as during periods of exacerbations.

Carrying out vitamin therapy

When the 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.

Disease prevention

As such, primary specific prevention of the described disease does not exist. 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. 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 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 react poorly to the exclusion of gluten from the diet, medical examinations are 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, 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 to ensure that the child is on the required gluten-free diet.

Hello dear readers. Today we will talk about what is the treatment of celiac disease. You will learn what this condition is, what symptoms indicate that your child has it, why it occurs. You can also find out what complications can occur in the absence of proper treatment, and what methods this condition is diagnosed with.

Classification

Celiac disease is a disease that is accompanied by a pronounced intolerance to gluten-containing foods. A negative reaction occurs due to the effect of this substance on the intestines of the child.

This pathology is mainly congenital in nature, often due to hereditary predisposition.

In such children, gluten that enters the intestines cannot be completely dissolved. Leads to the formation of toxic substances that adversely affect the walls of the intestinal mucosa. So the child may begin to vomit profusely, a foamy stool will appear, and bloating will begin.

Based on how the disease progresses, there are several forms of celiac disease:

• typical - characteristic changes in the functioning of the organs of the digestive system, intolerance to all dairy products;
• atypical - there are no specific symptoms, the disease can be detected during diagnostic studies;
• hidden - has no manifestations;
• latent - is in a dormant state.

Causes

To date, it is not completely known what exactly provokes the development of celiac disease in babies. Researchers take several directions in determining the root cause.

1. immunological character. It is believed that children with celiac disease have antibodies to gluten in their bodies. When this substance enters the intestine, lymphocytes begin to attack foreign objects, which damages its walls and mucous membrane.
2. enzymatic theory. It is based on the fact that in the body of such babies there is no special enzyme of the small intestine that can break down gluten.
3. Viral. It is believed that in patients with celiac disease, antibodies to adenovirus are found in the blood.
4. Pathoreceptor theory. It is based on the fact that such babies have violations in the structure of the walls of the intestinal mucosa, in particular, the pathology of the protein composition.

Most scientists are inclined towards the immunological theory.

At-risk groups

Children with Down syndrome are more likely to develop celiac disease

There are a number of children who have a significantly higher risk of developing celiac disease than others. These include babies with:

• down syndrome;
• autoimmune thyroiditis;
• Shereshevsky's syndrome;
• cases of celiac disease present in the family;
• Williams syndrome;
• selective deficiency of immunoglobulin A;
• type 1 diabetes.

Characteristic features

Weight loss is the first wake-up call

Children in their first year of life may experience the following symptoms:

• the presence of foamy mushy stools;
• rickets;
• early;
• slow growth;
• delayed teething.

Preschoolers are characterized by the presence of the following signs:

• diarrhea;
• flatulence;
• constipation;
• pain in the abdomen;
• loss of appetite or its complete absence;
• underweight;
• growth retardation;
• capriciousness, irritability.

Signs of celiac disease in schoolchildren:

• diarrhea or;
• bloating, increased accumulation of gases;
• feces are oily, float to the surface;
• a clear lack of body weight;
• lack of growth;
• thinning of the bones;
• anemia.

Celiac disease in children photo:

Signs of celiac disease: 1 - severe malaise; 2- very bloated belly

Skin manifestation:

• severe itching, burning;
• the appearance of blisters filled with liquid;
• may occur on the buttocks, elbows, neck, knees, face;
• due to the fact that the child itches a lot, the blisters are destroyed;
• the places where they burst are darkened;
• scars are formed.

Features of the teeth in children with celiac disease:

• there is a change in the color of tooth enamel;
• formation of pits and grooves.

Features of the skeletal system:

• in such children, bones are significantly weakened due to very poor absorption of vitamin D, as well as calcium;
• in this regard, the baby is much more prone to frequent fractures.

Diagnostics

In order to determine the presence of celiac disease in your baby, a personal examination of the child alone will not be enough. First, the doctor will collect a family history, find out complaints and send for examination.

Diagnosis of celiac disease in children includes the following studies:

• general blood analysis;
• capprogram;
• if necessary - colonoscopy;
• biopsy of the intestinal mucosa;
• intestines;
• venous blood test for celiac disease.

Possible Complications

Thinning bones can lead to frequent fractures

If the disease is diagnosed late or the requirements of therapy and diet are not met, the risk of developing serious consequences will significantly increase.

• the formation of an ulcer in the small intestine;
• development of infertility is possible;
• hypovitaminosis;
• lag in mental and physical development;
• significantly increases the risk of developing oncology of the digestive system;
• due to a decrease in bone density - frequent fractures, disability is possible;
• celiac disease (a child one year old and younger), in the absence of timely action, can be fatal.

Treatment

In addition to following a gluten-free diet, the child may be prescribed medications.

1. In order to restore the normal composition of the intestinal microflora, Linex, Aktimel or Hilak forte are prescribed.
2. To reduce bloating - Espumizan or Plantex.
3. To improve the digestion process - Creon or Pancreatin.
4. In the presence of diarrhea, Smecta or Imodium will be prescribed.
5. To normalize the water-electrolyte balance - Panangin or Calcium Gluconate.
6. With beriberi, a multivitamin complex will be prescribed.
7. If the cause is autoimmune pathologies, glucocorticosteroids are prescribed.
8. If there is a serious lack of muscle mass, a high-calorie diet will be prescribed.
9. If the child has a clear protein deficiency, amino acids and albumin will be prescribed.

Diet Features

1. It is unacceptable to use products that include barley, rye or wheat.
2. It is allowed to consume fresh vegetables, fruits, milk, fresh meat, corn, rice, potatoes, buckwheat.
3. You need to carefully study the labels on the products, the manufacturer indicates the presence of gluten in them. Such food will be unacceptable for your baby.
4. Some children have problems eating foods with lactose. If this happens to your baby, then it is better to give up such food for a while.
5. It should be borne in mind that oats can be contaminated with wheat, so you should be careful with it.
6. Pay attention to the inscription "gluten free".
7. If your child is diagnosed with celiac disease, be careful about everything he eats, monitor the reaction after eating each meal, keep a food diary.

Now you know what celiac disease in children is, the symptoms. It is important to notice the characteristic symptoms in time and consult a doctor for a referral for specific tests. Remember that it is important to diagnose celiac disease in time and start taking medications; in some cases, strict adherence to a gluten-free diet is sufficient.

Celiac disease is a condition in which there is an intolerance to gluten, or gluten. This substance is found in cereal plants. Gluten is found in barley, wheat, oats and rye. With this disease, it is strictly forbidden to eat these products. Usually celiac disease is diagnosed in children, the symptoms can vary in intensity. Another name for this condition is celiac disease.

Forms of the disease

Celiac disease in children is different. Doctors distinguish three forms of this condition. Each of them is characterized by a certain degree of severity of the main features.

1. Typical celiac. All symptoms of the condition are expressed quite clearly. With this form, it is not difficult to diagnose the disease.
2. Atypical celiac disease. Doctors call this form of oligosymptomatic. Signs of the disease are mild. In other words, this condition is characterized by erased symptoms. Diagnosing the disease in this case is more difficult. A number of additional surveys will be required.
3. Hidden celiac. Diagnosis of this condition is extremely difficult. The disease does not manifest itself in any way for several years. It is impossible to confirm the diagnosis without additional tests and examinations.

Gluten intolerance is a chronic condition. It is impossible to completely cure the disease. If the doctor has diagnosed the child with such a diagnosis, then a special diet must be observed throughout life.

Diagnosis of the disease

In some cases, characteristic symptoms signal the presence of a pathology of the digestive system. However, with sluggish forms, additional diagnostics are necessary.

A baby with suspected gluten intolerance should be shown to the pediatrician. Usually, doctors prescribe the following examinations:

• Ultrasound of the abdominal organs;
• x-ray of the intestine;
• colonoscopy;
• laboratory diagnostics.

Identification of the disease is carried out using laboratory tests. Specialists examine the child's feces, his blood, as well as samples of intestinal mucus.

There is no definite scheme for diagnosing celiac disease in children. The doctor focuses on the external manifestations and complaints of the parents. After that, various examinations are prescribed.

Illness detection in newborns

Celiac disease in a newborn child does not manifest itself in any way. This condition reveals itself only if an allergen enters the body. In celiac disease, it is gluten. If a woman exclusively breastfeeds her baby, then the likelihood of developing symptoms is low.

However, it should be remembered that all substances from the food of a nursing woman in a small concentration will be contained in her milk. Therefore, the first mild signs of the disease will appear in a newborn if the mother eats porridge from wheat or oats. A similar effect will be from bread and muffins.

Gluten intolerance is a hereditary disease. If it is diagnosed in parents, then the child is at risk. Such a baby is fed with caution.

In most babies, celiac disease is determined precisely with the beginning of accustoming to adult food. The baby reacts normally to the introduced vegetable purees, but after getting acquainted with cereals, digestive problems begin. For this reason, pediatricians advise choosing gluten-free cereals to introduce a child to cereals. Rice, buckwheat or corn are great.

Typical symptoms of the disease

What is celiac disease, the pediatrician will tell. This condition is accompanied by characteristic symptoms, according to which parents can suspect the disease.

1. Frequent defecation. If the chair is observed about 5 times a day, then perhaps this is provoked by gluten intolerance. Diarrhea is a frequent companion of celiac disease in children under one year old and older.
2. Liquefaction of feces. Watery stools and the appearance of impurities of mucus, fat or foam are signs of celiac disease. An unpleasant smell also indicates a problem.
3. Bloating. Another manifestation of pathology is bulging of the abdomen.
4. Lack of weight. A child with gluten intolerance eats well, but gains little weight. This is especially evident during the introduction of complementary foods.

All of these signs signal the presence of pathologies of the gastrointestinal tract. The child must be shown to the pediatrician. The doctor will order an examination.

Additional symptoms of the disease

Indirect signs can also indicate intolerance to gluten in a child. So, children with celiac disease are usually whiny and irritable. Opposite manifestations can also be observed - lethargy, drowsiness, fatigue.

Other additional features include:

• dry skin;
• dermatitis;
• low muscle tone;
• fragility of bones;
• bleeding gums;
• violation of posture;
• anemia;
• teeth problems.

A child with such a disease does not receive the necessary trace elements, vitamins and other nutrients from food. Later, with the onset of adolescence, problems with the reproductive system are noted. Girls may not have menstrual flow.

The need for a diet

If you suspect a gluten intolerance, your doctor will recommend avoiding such foods. The child should not be given bread and cereals based on the following cereals:

It is important to remember that there are products that contain a dangerous substance in a latent form. These are any canned food and semi-finished products. You can not eat sauces, seasonings, ice cream, sweets with filling. Gluten can even be found in baby food. For this reason, it is important to be especially careful in choosing food for complementary foods and further nutrition.

In the winter season, the child will receive the necessary carbohydrates from permitted cereals: buckwheat, corn, rice. Potatoes are allowed. Summer and warm weather allow you to eat fresh vegetable puree prepared without preservatives.

A diet for possible celiac disease in children is prescribed for at least 6 months. Next, the doctor analyzes the results of therapy. If the intensity of the symptoms has decreased, and the child began to feel better, the diagnosis is confirmed. Such children must follow a special diet throughout their lives.

Complications of celiac disease

Treatment for celiac disease in children is essential. The inability of the body to absorb gluten is due to the lack of essential enzymes. There is no medical treatment for this condition. Therapy is associated with adherence to a gluten-free diet. This is a necessary measure, since the lack of treatment threatens with complications.

Celiac disease is almost always accompanied by pain. The child experiences discomfort during bowel movements. After eating, the discomfort intensifies.

If measures are not taken and gluten is not excluded from the diet, the child develops allergic reactions. Edema is often observed. This is a consequence of a violation of protein metabolism.

Another complication of enteropathy is rickets. The bones of the child become brittle, often break. The posture is bent, scoliosis appears. Problems also begin with leather derivatives. Nails break and hair falls out. In children with celiac disease, tooth enamel is often destroyed, tooth decay appears.

Terrible complications of gluten enteropathy are:

• malignant neoplasms in the digestive tract;
• arthritis;
• diabetes;
• autoimmune disorders;
• pericarditis.

To avoid the development of dangerous conditions, it is important to start therapy in a timely manner. The child will be recommended special food. Vitamins will strengthen the immune system. Enzymatic and probiotic preparations will regulate the functioning of the gastrointestinal tract.

Celiac disease or celiac disease is an allergic disease in which the intestines cannot perceive and assimilate foods containing gluten. Celiac disease is considered a congenital disease that is transmitted from parent to child, but the mechanisms of the development of the disease have not yet been fully elucidated.

With celiac disease, gluten, entering the intestine, is not completely broken down, and as a result of incomplete breakdown, toxic substances are formed that injure the inner surface of the intestine. In young children, celiac disease begins to develop with the introduction of complementary foods, which parents can identify by: vomiting, frothy stools, worsening weight gain, bloating.

In the adult population, celiac disease masquerades as diseases of the intestines and stomach, which are chronic. In such cases, the patient can unsuccessfully treat unstable stools, flatulence and other diseases associated with dyspepsia for a long time, without suspecting gluten intolerance.

That is why official statistics are significantly underestimated and represent a percentage of cases equal to 1:1000. It is also widely believed that celiac disease is not a disease, but a lifestyle that requires dieting, because without contact with gluten, the development of celiac disease is impossible. The most toxic part of the digested gluten is gliadin (the alcohol soluble fraction).

Interesting facts about the disease

Celiac disease began to exist since the beginning of human consumption of cereals (rye, wheat), so the age of the disease is several millennia.

Women are more susceptible to the development of celiac disease, and it practically does not occur in Africans, Japanese and Chinese. Most likely, this is due to the peculiarities of nutrition or the genetic component.

Some regions of Russia still do not recognize celiac disease as a pathology, and doctors are prohibited from making such a diagnosis.

Some experts classify celiac disease as a precancerous condition that increases the risk of developing cancer of the digestive tract, small bowel lymphoma, and intestinal bleeding.

If parents suffer from celiac disease, the risk that a child will have such a pathology after birth is 1:10.

Causes

The exact causes of the development of celiac disease are still not known, but there are several theories of the occurrence of this disease. The most common are immunological and enzymatic, while the first is supported by most researchers.

Immunological

Autoimmune antibodies to the structures of the cells of the intestinal membrane and antibodies to gluten appear in the blood. In the presence of celiac disease, the number of intraepithelial lymphocytes with a specific set of receptors is increased. It is these cells that mistakenly identify gluten as a threat and damage the intestinal wall.

Enzymatic

The small intestine lacks an enzyme that breaks down gluten. This is a very likely reason, but not fully proven for the reason that dieting leads to the restoration of the enzymatic function of the intestine.

• virus theory

According to research scientists, about 90% of patients with celiac disease have an increased number of antibodies to a certain type of adenovirus. However, you should not believe the doctor if he says that celiac disease appeared due to adenovirus. It has nothing to do with a congenital disease, it's just that gluten has an antigenic resemblance to adenovirus.

Pathoreceptor

It is based on the assumption that the intestine has an abnormal composition of proteins, which leads to excessive sensitivity of the small intestine to gluten.

Most scientists agreed that the supposed picture of gluten intolerance includes all theories and combines them: no enzyme - gluten is not broken down and accumulates, which leads to a toxic effect on the intestine, which responds with a reaction of cells with special receptors. Such cells perceive gluten as a threat and attempts to destroy it lead to damage to the intestinal walls, which disrupt the process of digestion and assimilation of food. A possible initiator of the body's immune response to gluten, with this interpretation, is considered adenovirus.

Symptoms

In the medical literature, there are three clinical manifestations of celiac disease. The real picture of the disease has a variety of manifestations: celiac disease can be disguised as various diseases of the gastrointestinal tract, dermatological pathologies, hypovitaminosis and others. It is due to the variety of symptoms that celiac disease is diagnosed as a limited number of patients, while a larger number of celiac patients continue to be treated for false, but similar in symptoms, diseases.

In this case, there are cases when, all tests and clinical manifestations confirm the presence of celiac disease in a patient, but after a biopsy of the small intestine, the diagnosis of doctors is not confirmed.

It is also worth noting that the earlier foods containing gluten are introduced into food and the more there are, the faster celiac disease will begin to develop, while the nature of the course of the disease will be much more complicated.

Symptoms of celiac disease in children

A typical form of celiac disease is characterized by three striking symptoms:

Frequent stools (5 or more times a day), while it has a mushy texture, smells bad, foams, has a different color, shiny blotches of fat, is poorly washed off and there is a lot of it.

Bulging belly. Parents think that this is because the child eats well, the doctor can say that the reason is the development of rickets in the child.

The presence of a lag in weight and height. Especially noticeable is the lag in weight in the first two years of life and a noticeable lag in growth, after reaching the age of two. At the same time, the lack of weight gain begins to be observed after the introduction of complementary foods, although before complementary foods, weight gain took place at a normal pace.

Other symptoms that confirm the presence of celiac disease in a child are associated with a lack of nutrients, trace elements, and vitamins. For each specific case may be different:

Lethargy, fatigue or, conversely, increased irritability, aggressive behavior, tearfulness.

Unsatisfactory condition of the skin and hair: atopic dermatitis, skin peeling, dryness, weakness.

Exposure of the child to frequent fractures, at the slightest opportunity. It should be borne in mind that in a healthy child, the bones are much stronger than in adults, due to their elasticity.

Insufficient muscle tone (hypotension).

Wrong posture.

• The appearance of pathologies of the oral cavity: stomatitis, caries, fragility of enamel, bleeding gums.

  The child has a characteristic - unhappy appearance.

  The child has thin limbs and a large belly, which is why such children are compared to spiders.

With the growing up of a child with celiac disease, there are violations of the reproductive system: in boys - sexual dysfunction, in girls - the absence of the onset of menstruation.

Symptoms of celiac disease in adults

The symptoms of celiac disease in the adult population are characterized by a latent and atypical form. The manifestation of an atypical form is possible only after 30-40 years of life. This form of the disease is characterized by the presence of one of the main symptoms of a typical form of the disease and several concomitant ones. In general, extraintestinal manifestations of the disease come to the fore:

Dermatological: atopic and herpetiform dermatitis.

Neurological: depression, migraine.

Reproductive: infertility.

Articular: pain in the joints, the cause of which cannot be explained, arthritis.

Renal: nephropathy.

Changes in the biochemical analysis of blood: an increase in albumin, transaminases, alkaline phosphatase, a decrease in cholesterol.

Clinical studies have shown that 4-8% of women who have been treated for infertility, and it turned out to be ineffective, suffer from celiac disease. After the introduction of a gluten-free diet, they were all able to have a baby.

The latent form of the disease may not manifest itself in any way, except for irregular bowel problems or skin problems (dermatitis), which no one can associate with the disease. Therefore, celiac disease is detected only during a random examination.

Complications that occur with gluten intolerance

The long course of the disease in a latent form leads to an increased risk of developing serious diseases:

Autoimmune hepatitis, autoimmune thyroiditis.

Diabetes mellitus of the first type.

Rheumatoid arthritis.

Oncology of the gastrointestinal tract.

Recurrent pericarditis.

Scleroderma, myasthenia.

Diagnosis of the disease

In most cases, celiac disease is detected during a comprehensive diagnosis of the body in the process of confirming the diagnosis of one of the diseases listed above. Targeted diagnosis of celiac disease includes three stages:

The first is an immunological study of the patient's blood. During the study, the presence of tissue transagglutaminase, autoimmune bodies to reticulin, endomysium, and the level of antigliadin antibodies are determined.

Second - if the first stage has positive test results, then a biopsy of the small intestine mucosa is performed, which includes determining the presence of lymphocytes with atypical receptors, inflammation, and the general condition of the villi. The second stage is the most important for making the correct diagnosis.

The third is the appointment of a gluten-free diet and observation of the patient by a doctor for 6 months. If the general condition improves, there is a reverse development of the symptoms of the disease - the diagnosis receives 100% confirmation.

The peculiarity of the treatment lies in the fact that even with negative biopsy results, a patient with positive immunological tests is assigned the third stage of diagnosis. If the patient's condition improves within six months, the diagnosis of celiac disease is confirmed, and this form of the disease is called potential.

Repeated immunological examination is carried out a year later, the appearance of positive dynamics is expected. After two years, a repeat biopsy should confirm the complete restoration of the villi of the small intestine.

Differential Diagnosis

Usually, doctors are in no hurry to make a diagnosis of celiac disease, and even more so to prescribe an intestinal biopsy. Initially, celiac disease must be distinguished from hereditary bowel diseases, intestinal infections, immunodeficiencies, food allergies.

Celiac disease differs from the listed pathologies in the good effect of following a gluten-free diet (assigned in case of a positive response to an immunological examination of atypical antibodies), the absence of blood and mucus in the feces.

Treatment

Lifelong adherence to a gluten-free diet is the only effective treatment. A characteristic diet for celiac disease involves the exclusion of bakery, confectionery, cheap sausages, sausages, meatballs, sauces, some cereals (semolina, pearl barley, oatmeal), pasta. Also, latent gluten can be found in beer, kvass, malt extract, dyes, coffee, cocoa, canned food, ice cream, curds and yogurt, cheese, ketchup, mayonnaise.

Critical for an allergic person is the content of more than 1 milligram of gluten per 100 grams of product.

Approved for use:

Natural dairy products, eggs.

• Fish, meat.

  Fruits vegetables.

  Millet, corn, buckwheat.

  Marmalade, chocolate.

For children, special mixtures are prescribed, which are based on soy or casein hydrolyzate. For the introduction of dietary complementary foods, special gluten-free cereals are used. After the diagnosis is established, therapy is reduced to reducing the manifestation of symptoms:

Improving digestion with pancreatic enzymes (Pancreatin, Creon).

Correction of intestinal microflora: prebiotics (Hilak Forte), probiotics (Actimel, Linex, Bifiform), intestinal antiseptics (Enterofuril).

Treatment of diarrhea: Imodium, Smecta, decoction of oak bark.

Treatment of bloating: Plantex, Espumizan.

Therapy of hypovitaminosis: intravenous administration of vitamins K, D, E, B, A, nicotinic acid (in severe cases), multivitamins inside.

Hypotrophy treatment: increase in calorie content of food, nutrition correction.

Elimination of protein deficiency: albumin, mixtures of amino acids.

Correction of water and electrolyte balance: calcium gluconate, Panangin.

Treatment of autoimmune diseases with glucocorticosteroids.

The patient undergoes simultaneous therapy for celiac disease and monitoring for concomitant diseases, for example, diabetes mellitus.

In no case should you take medicines (pills and tablets) whose shell contains gluten (for example: Festal, Mezim Forte, Complivit). It is also worth paying attention to the composition of liquid preparations and excluding preparations containing malt (Novo-passit), which is contraindicated for use by patients with celiac disease.

Celiac disease is not a sentence

Most children, upon confirmation of the established diagnosis of celiac disease, receive a disability, but in the case of strict adherence to a properly designed diet, the prognosis is quite favorable. After a few weeks, the intestinal symptoms of the disease disappear, and within the first couple of months, the protein, water-electrolytic, vitamin-mineral balance is completely restored.

A child who follows all the points of therapy for the disease is able to catch up with his peers in height and weight. However, adherence to a gluten-free diet should be carried out for life, because malnutrition, and with it the progress of the disease, can lead to the development of oncological diseases of the gastrointestinal tract and the return of all pathological phenomena.