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Magazine
HEALTHWATCH
A digestive disorder
DR. SARATH GOPALAN
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Keep an eye on kids who don’t seem to grow properly. They could be suffering from celiac disease.
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Photo: P.V. Sivakumar
Common problem: Gluten intolerance is rarely detected in children.
What is celiac disease?
It is a disorder caused by intolerance to the protein called gluten found in wheat, rye, oats, and barley. When a person with celiac disease eats food items containing these ingredients, the mucous membrane lining the small intestine is gradually damaged.
This, in turn, leads to failure to absorb nutrients effectively and results in growth failure. The condition must be kept in mind in the case of children who are short and thin without a plausible explanation.
Why does it occur?
Individuals with celiac disease are unable to breakdown and digest the gluten protein. This leads to all the problems.
At what age does it occur?
Any age (even adults), but 80-90 per cent, individuals are diagnosed when they are between five to 10 years of age.
Is it common?
More common than we think! Many children with celiac disease remained undetected or were wrongly diagnosed and treated in previous years owing to both lack of appropriate diagnostic facilities and lack of awareness.
How does it manifest in children?
Growth failure alone or growth failure associated with symptoms related to the digestive system (repeated abdominal pain, loose stools, constipation, bloating).
Why is early detection important?
Celiac disease is an important cause of growth failure in children. A considerable proportion of children suffering from celiac disease appear very short and thin but have no digestive tract symptoms like abdominal pain, bloating or loose stools. They perform well in school and are active and alert. These are very likely to escape early detection. Such children will end up as short adults and very late detection will not help in bringing about significant change in height.
How can celiac disease be diagnosed?
A simple screening test is available. If it seems likely consult a specialist in digestive diseases of children for further steps to confirm the diagnosis.
How can a child with celiac disease be managed?
The approach is very different from most medical diseases, which rely mainly on drugs.
In celiac disease, diet modification is the main aspect of treatment, not drugs. So the involvement of a dietician is very important.
What is the ultimate outcome?
Children with celiac disease grow normally and lead a very active life but compliance with dietary advice is essential.
Every child who receives proper intervention after diagnosis grows normally and lives a normal life.
The writer is a Senior Consultant, Paediatric Gastroenterology and Nutrition, based in New Delhi.
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