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Offered by: Richard W. Martin, M.D. – Brighton Pediatrics, P.C.

Imagine being the only child at a birthday party who can’t have a piece of cake. Celiac disease is an autoimmune disease triggered by the ingestion of gluten in genetically susceptible children. Gluten is a complex protein found in wheat, barley, and rye. For a child with celiac disease, the gluten in as little as 1/250th of a piece of bread can damage the inner surface of the small intestine that absorbs nutrients and cause a range of problems. About one person in one hundred has celiac disease.

Celiac disease may be difficult to recognize because the symptoms are shared by so many other disorders. Confusingly, celiac disease may present with diarrhea but almost as frequently with constipation. It may also present with abdominal
pain, nausea, vomiting, and weight loss. Surprisingly, celiac disease may also cause problems as varied as hair loss, anemia, recurrent mouth sores, depression, and delayed puberty.

If your child’s doctor thinks your child might have celiac disease, she or he can order a blood test that measures antibodies against the enzyme tissue transglutaminase, which is increased in celiac disease. It is still recommended
to confirm the diagnosis with an upper GI endoscopy, because following a lifelong gluten-free diet is both necessary and difficult.

For a child with celiac disease, ingestion of even a tiny amount of gluten may cause damage to the lining of the intestine that takes months to heal. Any food that contains any form of wheat, barley, or rye must be carefully avoided.
Although oats are inherently gluten free, they are often contaminated in the harvesting and milling process. Therefore, only oats that are labeled as gluten free should be eaten. Eating out can be difficult unless a restaurant has a gluten-free menu. It may not always be obvious when foods contain gluten—for example, soups and sauces that are thickened with flour, chicken that has been dipped in flour, or meatballs mixed with flour. It is important to check ingredient labels carefully. Fortunately, more gluten-free alternatives are becoming available in grocery stores with a certified gluten free label.

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