Coeliac disease

What is Coeliac Disease?

Coeliac disease is an autoimmune disorder affecting mainly the digestive system. Autoimmune diseases occur when the body’s immune system attacks normal tissues. In other words, the body fights itself.
With autoimmune disorders, the immune system goes into “overdrive” and can cause lasting damage to organs. Examples of other autoimmune conditions include type 1 diabetes and rheumatoid arthritis.
In coeliac disease, the immune system becomes active when gluten, a protein present in certain grains, is ingested. You can find gluten in foods containing wheat, rye, and barley. Gluten causes structures in the small intestine to become inflamed, leading to problems with nutrient absorption.
Coeliac disease can result in severe complications such as malnutrition, bone density problems, and dental issues if the condition is left untreated. However, an accurate diagnosis of coeliac disease means that effective management can begin, and these problems can be largely avoided.

What Causes Coeliac Disease?

Coeliac disease is not limited to any age range or gender. It may appear in childhood or adulthood. Even infants may develop coeliac disease.
Researchers have not yet discovered the exact cause of coeliac disease. However, we do know that there is a genetic component. So, coeliac disease can run in families. This does not mean that a child with no family history of coeliac disease will not develop the disorder. Though, children who have family members with coeliac disease are at a greater risk of the illness themselves.
There are also several known risk factors for coeliac disease, discussed below.

What are Common Coeliac Disease Symptoms?

Coeliac disease shares many symptoms with other digestive illnesses, such as wheat allergy and gluten intolerance. For this reason, it is essential to consult with a specialist for a definitive diagnosis.
The symptoms include:

• Nausea, vomiting, fatty stools, diarrhoea, flatulence, and abdominal pain, particularly immediately after a meal or a few hours subsequent to eating.
• Stiffness or pain in the joints
• Slow or delayed growth and development, physically and/or mentally
• Extreme or persistent fatigue or tiredness
• Easy bruising
• Problems with significant weight gain or loss
• Frequent irritability or listlessness
• Depression
• Poor teeth condition sometimes with ulcers or swelling in the mouth
• Iron-deficiency anaemia

What are the Risk Factors for Coeliac Disease?

The primary risk factor for coeliac disease is a family history of the disorder. Other risk factors include stomach or other gastrointestinal infections in childhood or a history of other health problems, like type 1 diabetes, thyroid disease, Down syndrome, epilepsy, and ulcerative colitis.

What is the Treatment for Coeliac Disease?

There is no way to reverse or eliminate coeliac disease, but it can be managed successfully through gluten avoidance. Children with coeliac disease and their parents need to undergo education on choosing foods that are gluten-free. Gluten avoidance not only lessens or eradicates coeliac disease symptoms, but this practice also prevents damage to the small bowel. Having a healthy small bowel is crucial for proper nutrient absorption, growth, and development.
A specialist can often diagnose coeliac disease through a straightforward blood test, but a small bowel biopsy is sometimes necessary. The physician will also take a detailed medical history from yourself and your child, if possible. This history will include previous diagnoses, tests, medications, details about your child’s diet, your child’s symptoms, and more. A medical history is invaluable for an accurate diagnosis.

When Should I Bring My Child to a Specialist?

Paediatric gastroenterologists are the medical specialists best suited to deal with coeliac disease in children. It can be challenging to know when your child needs to see a specialist, but here are some tips on when to schedule a visit:

• When recommended by your child’s paediatrician
• If your child frequently has stomach pain, nausea, diarrhoea, vomiting, bloating, gas, etc., especially after eating foods containing wheat, rye, or barley
• If your child does not seem to be growing normally or if they are developing slowly
• When there is a family history of coeliac disease
• When your child has unexplained weight loss or gain