Coeliac disease
coeliac; celiac; gluten; enteropathy; bowel; intestine; sprue; malabsorption; diarrhoea; wheat; rye; barley; oats; rice; diet; cereal. ;
Contents
In people with coeliac disease, gluten (a protein in many cereal foods such as wheat, rye, barley and possibly oats) causes damage to the lining of the small intestine (bowel). This damage affects the digestion of foods and nutrients. Nutrients are not absorbed properly, causing a range of health problems. This intolerance to gluten is sometimes called Gluten Sensitive Enteropathy or Sprue.
If you think you might have coeliac disease it is important not to start a gluten free diet until the diagnosis is made as it may make it harder to work out what is wrong. It is important to know for sure are if you have coeliac disease as the diet needs to be lifelong.
- As long as people with coeliac disease do not eat foods containing gluten they feel quite normal and healthy.
- Coeliac disease happens in about one out of every 100 people in Australia but most people who have it do not know that they do. It can be inherited, that is it can run in families.
- Coeliac disease can start at any time after cereals containing gluten are given to a baby, often between 9 months and 2 years. (Rice cereal does not contain gluten.) It can also be found in older children or adults.
- Slow growth or weight loss (failure to thrive)
- Diarrhoea (large, foul-smelling poos) or sometimes consitpation
- Swollen abdomen
- Irritability, grizzling
- Anaemia
- In some people the symptoms may be mild enough that the coeliac disease is not picked up until later childhood, or even until the person is an adult.
How do you find out if someone has it?
- It is important to see a doctor if you are concerned your child has some of the signs of this disease. Other, more common causes of these signs (such as infections) need to be looked for first.
- Your doctor may do some blood tests and poo tests to help sort this out.
- If coeliac disease is likely, the main test involves taking a biopsy of the lining of the small bowel. This means getting a very small bit of the lining of the bowel to look at under a microscope. To do this, an endoscope or thin tube is passed down to the child's stomach through the mouth. This is done with a light general anaesthetic, and is not likely to cause any problems.
How is it treated?
- The main treatment is to make sure the person does not eat any food containing gluten. On a gluten free diet the lining of the small bowel will heal, and the person will be able to absorb other foods normally. People with Coeliac disease grow and develop normally while they stick to their gluten free diet. Australian Food Standards Code requires that foods that contain gluten in them have this written on the label.
- This means not having anything containing wheat, rye, barley or, in most cases, oats. Rice is the main cereal that does not have gluten.
- So most breakfast cereals, bread, pasta, cakes and pastries need to be avoided, though it is possible to buy gluten-free alternatives to some of these.
- Many processed foods contain flour with gluten, so it is important to read labels carefully.
- Keeping to a gluten-free diet is quite difficult, especially for older children and teenagers, as most popular "fast foods" such as hamburgers and pizza are not suitable.
- The diet needs to continue for life to prevent complications. Adults with untreated coeliac disease are more likely to get cancer of the bowel.
- For all these reasons, when coeliac disease is diagnosed, it is important to see a dietician to work out a suitable diet to meet all of a child's needs for growth and development.
Can coeliac disease be prevented?
- There is no certain way to prevent or permanently cure coeliac disease.
- The onset of the disease may be at least delayed by not introducing gluten-containing cereals to very young babies. This is one reason that rice cereal is the only cereal food that should be given if solids are started before 6 months. Other cereals can be tried gradually after 6 months.
Resources
- The Coeliac Society of Australia has branches in every state, and provides a lot of information, support and help for families coping with this disease. There is a video and a range of booklets available. The website address is http://www.coeliac.org.au
References and further reading
Better Health Channel (Victoria) 'Coeliac Disease'
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Coeliac_disease
Medlineplus 'Celiac disease' http://www.nlm.nih.gov/medlineplus/celiacdisease.html
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).
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