Coeliac disease: A quick and easy guide

What is coeliac disease?

Coeliac disease is one of the most common chronic diseases, affecting 1 in 100 people in the UK. It is often undiagnosed or misdiagnosed. It is neither an allergy nor a food intolerance, but a lifelong autoimmune disease.

In coeliac disease the trigger for the body attacking itself is gluten, the protein found in wheat, rye and barley. Gluten is usually introduced in childrens’ diets by 6 months of age. However, symptoms of coeliac disease may not be identified until adulthood.

Oats are generally contaminated with wheat and barley and are therefore unsuitable for people with coeliac disease. Although most people can tolerate uncontaminated oat products, some people with coeliac disease may be sensitive to protein similar to gluten found in oats, avenin.

When people with coeliac disease eat gluten, the lining of the gut becomes damaged. Projections called ‘villi’ become inflamed and flattened so there is less surface area to absorb nutrients. This results in a range of symptoms and nutritional deficiencies. Symptoms to be aware of in children include:

– failure to thrive or meet growth targets

– muscle wasting in the arms and legs

– iron deficiency and anaemia

– distended tummy, stomach pain or discomfort, nausea, wind, diarrhoea and/or constipation

– loss of appetite and – irritability

If you suspect that your child has coeliac disease, there are two steps to diagnosis.

1. Symptoms should be discussed with the GP and if coeliac disease is suspected they will carry out a blood test. Specific blood tests detect antibodies resulting from eating gluten. The GP may not do any blood tests on children but may refer directly to a paediatrician or paediatric gastroenterologist.

2. Depending on the outcome of the test, the child will be referred to a paediatrician or paediatric gastroenterologist who will carry out a small intestine endoscopy with biopsy to show the typical damage to the gut lining.

It is essential that a child continues to eat gluten throughout the diagnosis process, otherwise it is not possible to make an accurate diagnosis.

TREATMENT

The gluten-free diet is the only medical treatment for coeliac disease. The cereals wheat, barley, rye and ingredients derived from these cereals must be avoided. The gluten-free diet includes:

1. Naturally gluten-free foods such as fruits, vegetables, meat, poultry, fish, milk, cheese, potatoes, rice and pulses;

2. Processed foods which are gluten-free, such as ready meals and soups. The Coeliac UK Food and Drink Directory lists approximately 10,000 suitable products.

3. Gluten-free substitute foods such as specially made gluten-free bread, flour, pasta, crackers and biscuits. These are available on prescription and in the Free From aisle of supermarkets.

Pure, uncontaminated oat products are available from specialist manufacturers and are also listed in the Coeliac UK Food and Drink Directory. They should only be introduced under the supervision of a healthcare team.

The reaction to eating gluten varies between children and the reaction is not like an anaphylactic reaction. Eating gluten by mistake is unlikely to do any long term damage to the gut, although regular ingestion can do damage, the effects of which may last longer than any symptoms.

The reaction to eating gluten varies between children and the reaction is not like an anaphylactic reaction. Eating gluten by mistake is unlikely to do any long term damage to the gut, although regular ingestion can do damage, the effects of which may last longer than any symptoms.

If the child does eat gluten and suffers from diarrhoea or vomiting, it is important to keep them hydrated, so drinking fluid is recommended. If symptoms persist, the child should see the GP. The most important thing is to keep to the gluten-free diet to prevent further symptoms.

Understanding coeliac disease

It is important to explain to children who are diagnosed what coeliac disease is, what gluten does to their bodies, what foods they should avoid and answer any questions they might have about their condition.

Coeliac UK has a booklet for children up to seven years of age which explains coeliac disease and how it affects the body in easy-to-understand words using bright and colourful pictures. It can also be used as an educational tool in schools and nurseries. Coeliac UK’s website provides advice on talking to school catering teams about school dinners. There is also information about packed lunch ideas, gluten-free parties, birthday cake recipes, play activities and much more.

The reaction to eating gluten varies between children and the reaction is not like an anaphylactic reaction. Eating gluten by mistake is unlikely to do any long term damage to the gut, although regular ingestion can do damage, the effects of which may last longer than any symptoms.

Explaining coeliac disease to the whole family and close friends is a key step in getting used to the gluten-free diet. Everyone can help make the gluten-free diet an accepted routine. Often a child will want to introduce their new diet and foods to friends!

HOW COELIAC UK CAN HELP

Coeliac UK is the UK’s leading charity for people with coeliac disease.

TFor further information contact Coeliac UK www.coeliac.org.uk – Helpline 0845 305 2060 – open Monday, Tuesday, Thursday, Friday 10am to 4pm and Wednesday 11am to 4pm.

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