Caring for a Child with Celiac Disease

Have you ever wondered why your child has difficulty in gaining weight, or maybe he or she is not gaining weight at all? Does your child experience abdominal pain, bloating, or even diarrhea when they eat foods with wheat, barley, rye, and the like? Is your child always weak and sickly? If he or she is experiencing all of these, maybe it’s time to ask yourself: What if my child has celiac disease?

Why must gluten be avoided for celiac positive patients?

Celiac disease, also known as celiac sprue or gluten-sensitive enteropathy, is a serious genetic autoimmune disorder, which is triggered when consuming gluten. Gluten is the general term for the proteins found in wheat, barley, and rye. A hybrid of wheat and rye is called triticale. When children with celiac disease consume foods containing gluten, their immune system reacts and damages the intestinal villi. These villi are finger-like projections in the intestines, which specialize in the absorption of nutrients in the foods we eat. When the villi are damaged, the small intestines lose its ability to absorb nutrients needed by the body to grow, resulting in malnutrition of children.

When can I say that my child has celiac disease?

The signs and symptoms of celiac disease may appear at any time of the child’s life after he or she starts to eat foods and take medicines with gluten. There are a lot of symptoms for this type of disease, which may vary from each individual.

A baby may start showing the symptoms at the time he or she starts to consume solid food like cereals. These symptoms may include stomachache, diarrhea, or bloating. Other symptoms such as skin rashes around the elbow, buttocks, and knees might also appear. If left untreated, celiac disease might trigger the emergence of other diseases such as anemia, type 1 diabetes, multiple sclerosis (MS), dermatitis herpetiformis (itchy skin rashes), infertility and miscarriage, intestinal cancer, osteoporosis, migraine, and epilepsy. Celiac disease may also lead to malnutrition, lactose intolerance, mouth problems like canker sores and dry mouth, missed menstrual periods, delayed puberty, weight loss, seizures, tingling and numbness in the hands and feet, and loss of calcium in the body. Thus, it stops children from growing properly, damaging their permanent teeth’s enamel, and weakening and making their bones brittle.

For this reason, as a parent, you must check any signs that could hint that your child might be positive with celiac disease. An early diagnosis will help you stop the disease from worsening, and preventing other health complications from happening.

Why do the symptoms of celiac disease vary?

Celiac disease symptoms vary because of several reasons. It may include the duration of the period where an infant was breastfed. Studies have shown that the longer an infant was breastfed, the later and lesser celiac disease symptoms appear. Other symptoms such as bloating, constipation, or stomachache also depend on the amount of gluten that was taken. Symptoms may also vary depending on the age the child started to eat gluten, as well as the amount of damage to the small intestines.

What are the chances that my child has celiac disease?

The causes of celiac disease are not really known. Doctors found some links to celiac disease from other major health conditions including Down syndrome, Williams syndrome, thyroid disorders, diabetes mellitus, and IgA deficiency. Researchers attempted to study and understand what triggers the immune system of a celiac disease patient to react to gluten but failed to do so. However, most cases of celiac disease were traced down to their family genes. If you have family members or relatives who have celiac disease, there are chances that you or your child has celiac disease, too. Therefore, consider having your family members tested as they may have the disease but without symptoms yet.

Testing and Diagnosing Celiac Disease

If you think your child or any of your family members might have celiac disease, talk to your doctor about getting tested. You could ask your doctor about the testing procedure, the risk of having celiac disease, as well as the treatment of such disease. In diagnosing celiac disease, the patient must consume gluten. Then, a simple blood test is conducted to check the level of antibodies to gluten and other proteins in the lining of the small intestines. If the blood test result indicates celiac disease, the doctor may recommend the patient to have a biopsy of the small intestines and send it to the laboratory for further testing.

In testing a patient whether he or she has celiac disease or not, the doctor may conduct either the tissue transglutaminase antibodies, also called the tTG-IgA test or the genetic test. The tTG-IgA test is positive for about 98 percent of patients who have celiac disease. Patients should be on a gluten-filled diet so that the test will work. If the same test is conducted on healthy people without celiac disease and yields a negative result in 95 percent of the total tested population, it becomes the test’s specificity. It means that there are patients who have celiac disease, but still yields a negative antibody test result. However, such case is very rare.

There are other antibody tests available to confirm the previous test result or for seeking a second opinion as there might be a slight chance of having false negatives or false positives in the first test. Just to be sure, a biopsy of the small intestines should be conducted to positively diagnose celiac disease. Another way of testing celiac disease is through genetic testing. Patients with celiac disease usually carry HLA-DQ2 and HLA-DQ8 genes (either one of these or both). If you have these genes, the risk of developing celiac disease is 3 percent instead of the general population risk of 1 percent.

It is also said that celiac disease usually runs in the family. Therefore, testing a person's genes would also be effective in diagnosing celiac disease. First-degree family members who have the same genotype of the patient with celiac disease have a 40 percent risk of having the said disease. Hence, have your child tested to clarify any symptoms that are showing before it is too late.

As a parent, what should I do if my child has celiac disease?

Parents of children with celiac disease would sometimes feel frustrated with the condition their children have as there is no known medication to treat celiac disease. However, there are various ways to lessen the symptoms experienced by the children who are diagnosed with the disease. Below are the tips for parents who have a celiac-positive child:

• Check the label: As a parent of a celiac disease patient, be cautious of the food that you give to your child. Always check the label to spot the ingredients that contain gluten.

• Promote a gluten-free diet: In preparing your food at home, avoid wheat, rye, barley, and any foods that contain gluten. It would be preferable to have a 7-day gluten-free meal plan. It is also recommended to let your child bring his or her own food to school or when going to field trips.

• Supplement nutrients: As celiac disease may block the absorption of nutrients essential to our bodies, it would be preferable to have vitamin supplements. Since the damaged villi are not capable of absorbing nutrients from the food we take, try to consult your doctor regarding suggested vitamin supplements to avoid malnutrition.

Conclusion

Celiac disease may not be as well-known as other diseases like cancer and tuberculosis, but the discomfort and inconvenience it gives to the patient are draining and depressing. Therefore, full parental support is highly suggested to help children cope with the accompanying stress and depression caused by the disease. As a parent, you are not only a caregiver to your child--your responsibility is far-stretched to being a personal psychiatrist and confidant whenever your child need's someone to express how he or she feels.