Celiac disease is an inherited autoimmune disorder in which a person cannot digest gluten, a protein in wheat, barley, and rye. Gluten does not bother most people, but it attacks the body of a person who has celiac disease. Symptoms of the disorder can include bloating, diarrhea, constipation, or non-gastrointestinal symptoms such as headaches, anemia, leg pains, weight loss, stunted growth, and irritability. Anca Safta, M.D., a gastroenterologist and an assistant professor of pediatrics at the University of Maryland, calls the disease "the great chameleon" because its symptoms can take so many forms.
What causes this disease? Celiac sufferers harbor certain genes that interact with gluten in harmful ways. Not everyone with these genes develops celiac disease, however. And someone who for years has had no problem eating gluten can suddenly get sick from it. No one knows what triggers this reaction, but the good news is that it's treatable.
Breastfeeding seems to help prevent, or at least delay, the onset of celiac disease, possibly by introducing tiny amounts of gluten to a baby through the mother's milk. The benefit may stem from differences in intestinal bacteria. While all human beings harbor a large and varied population of intestinal bacteria, a single species, Lactobacillus bifidus, makes up more than 90 percent and sometimes more than 99 percent of the total bacteria in the feces of a nursing infant. L. bifidus is also present in the stool of the formula-fed baby, but in a smaller amount.
People with celiac disease have fewer bifidobacteria in their guts than do people without the disease. When gluten is present in human intestinal cells in test tubes, bifidobacteria allow the cells to tolerate gluten instead of becoming inflamed. Thus, the abundance of bifidobacteria in the intestines of breastfed babies may make them less likely to develop this disease.
The strongest protection found thus far seems to be continuing to breastfeed after the child is 6 months old and while you are introducing gluten, says Alessio Fasano, M.D., director of the Center for Celiac Research at Massachusetts General Hospital for Children, based on a recent study he conducted with colleagues.
If you suspect your child has celiac disease, speak with your pediatrician to have her tested as soon as possible. Celiac disease is diagnosed through blood tests to determine the presence of antibodies against substances associated with a reaction to gluten. These tests must be performed while a person's diet contains gluten, so if you suspect that your child has the disease, it's crucial that you continue to give her gluten-containing foods until after the testing is complete. If the blood tests are positive, the doctor will usually perform an endoscopy to confirm the diagnosis. In this procedure, the child receives anesthesia, and then a thin, flexible tube is inserted through the mouth and into the intestines.
Some people don't test positive for celiac disease, but they do react to gluten. "Gluten sensitivity is more controversial than celiac disease," Dr. Safta says. "It's like a headache: A person has real symptoms, but we can't find any positive proof of what's behind them. However, when we take gluten out of the diet, the person feels better."
Once a child has celiac disease, she needs to adhere to a strict lifelong diet that completely avoids any gluten-containing foods, beverages, and even medications.
Gluten-free crackers, cookies, pasta, pancake mix, bread, meatballs, and a host of other common foods that are ordinarily made with wheat represent the food industry's enthusiastic response to the demand for these products. But even if a food is labeled "gluten-free," parents should be hyper-vigilant about checking ingredients, monitoring diets, and asking questions. The Food and Drug Administration passed stricter labeling regulations for these products by August 2014. Meanwhile, Dr. Fasano recommends that parents consult a knowledgeable dietitian to help plan their child's diet.
Sticking with the diet isn't hard. When children realize that they feel better, they're motivated to stay with it. "Switching Josh to a gluten-free diet was actually a lot easier than I thought it would be," says Bethany Hicks, of Colonie, New York, who writes a blog about celiac disease. "We made the transition fun by going to a local gluten-free bakery and getting special treats." Parents learn to keep gluten-free cupcakes and pizza in their freezers to bring to their children's social events. "Keeping your child socially active is important. Celiac kids are normal kids, just like everyone else -- they just have to be careful what they eat," says Stacey Juhnke, of Fargo, North Dakota, mother of two children with celiac disease and one without it.
Healing begins with a good diagnosis, and it's important that the diagnosis comes early in a child's life. Ritu Verma, M.D., founder and director of the Center for Celiac Disease at Children's Hospital of Philadelphia, advises, "If you as a parent think there is something not okay with your child, tell your pediatrician, be persistent, ask for the celiac blood tests, and keep looking for answers."
If you're not satisfied with the answers, you might get help by going to the closest university hospital, where the medical staff is likely to be knowledgeable about celiac, as well as other disorders that may be at the root of your child's problems.
Sally Wendkos Olds is the author of The Complete Book of Breastfeeding.
Copyright & copy 2013 Meredith Corporation. This story has been updated from it's original version.
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