Celiac disease is a rather unpleasant but common disease caused by intolerance to plant foods, which found in many products(mainly cereals) and dishes prepared from them.

Symptoms of celiac disease in children are expressed very clearly and cause a lot of inconvenience to the child. In this case, the disease can have a severe course, resulting in significant deterioration general state child's health.

In some particularly dangerous cases, celiac disease can even lead to disability. That is why, having noticed the first signs of the disease, it is necessary to begin treatment as soon as possible, which consists of taking medications prescribed by the doctor, following a diet and a proper lifestyle.

Unfortunately, it is impossible to completely get rid of this problem; celiac disease is an incurable disease, however, following the recommendations of the attending physician will significantly improve the child’s quality of life and avoid serious complications.

How does an allergy to formula manifest in an infant? Find out about this from ours.

Characteristics and facts

Celiac disease is congenital or acquired disease, which has a chronic course and cannot be completely cured. In some cases, the child’s body reacts negatively to certain elements contained in food.

If we're talking about About celiac disease, such an irritating ingredient is gluten - a plant protein (gluten) that is part of some food products. Largest quantity gluten free found in cereals, such as rye, oats, .

At the same time, the child often exhibits intolerance to other components similar in composition to gluten (avenin).

These substances, entering the child’s intestines, cause him irritation, which negatively affects not only the functionality of this organ, but also the condition of other organs digestive system. As a result, specific symptoms of celiac disease occur.

Characteristic feature This disease is due to the fact that the condition of the child’s digestive system quickly improves and is restored provided there are no gluten-containing products in the diet.

Celiac disease in children can occur asymptomatic(hidden form), with the appearance characteristic features intestinal lesions (typical form), or with the manifestation of symptoms of damage to other organs of the digestive tract (atypical form).

There are also several stages of development diseases:

1. At the initial stage, there are no symptoms of the disease.
2. The composition of the blood changes, in particular, the level of leukocytes and red blood cells increases.
3. Available minor damage cilia of the intestinal epithelial layer.
4. The cilia are damaged to a greater extent, and signs of atrophy are observed.
5. An irreversible process of damage to the intestinal epithelium.

Causes

Currently, the exact cause of the development of celiac disease in children has not been established, however, there is reason to believe that this disease occurs as a result of such unfavorable factors as:

There are also numerous minor factors, the presence of which can provoke the development of the disease. These factors include:

• infectious diseases that cause disruption of the digestive system;
• surgical operations or traumatic injury to the gastrointestinal tract;
• long-term decrease in immunity;
• some diseases, such as rheumatoid;
• congenital or acquired changes in the structure of the intestine.

Symptoms and signs

How does the disease manifest itself? Celiac disease is difficult to recognize at the initial stage of its development, since the symptoms of the disease appear not from the moment of birth.

And when the child reaches 6-7 months of age(sometimes this happens much later), even if we are talking about a congenital form of the disease.

If the child is on breastfeeding, signs of pathology appear when the child’s diet becomes more varied (introduction of complementary foods), and cereal porridges and other gluten-containing products appear in the baby’s daily menu.

To the number characteristic features pathologies include:

1. Insufficient gains in height and weight.
2. Sudden mood swings (the child can behave actively, aggressively, is often capricious, and after some time this state is replaced by a period of lethargy and apathy).
3. Changes in stool. The number of bowel movements increases, and the stool acquires a liquid, foamy consistency and an unpleasant odor.
4. The appearance of paroxysmal abdominal pain.
5. Signs (photo).
6. Anomalies of the dentition (the baby’s teeth are much later than expected, while the enamel of the teeth has increased sensitivity, as a result of which the child often develops caries).
7. Swelling.
8. Intolerance to animal protein, which is contained in cow's milk and products based on it.

Complications and consequences

Disability

However, if the disease is severe and rapidly developing, and the child does not receive the necessary treatment, disability is possible.

Thus, celiac disease negatively affects the general condition of the child’s body, in particular, the condition of his musculoskeletal system. And such disorders, leading to frequent fractures, can cause disability.

Diagnostics

To make a diagnosis, the doctor needs to evaluate the child's condition after eating foods containing gluten. To do this, the child is examined and interviewed, and additional research methods are prescribed, such as:

Treatment options

Therapy for celiac disease must be comprehensive, in particular, the child must take medications prescribed by the doctor and adhere to rules of a gluten-free diet.

In addition to this, the use of traditional methods treatments that have a positive therapeutic effect during exacerbation of the disease (herbal decoctions that normalize the functioning of the gastrointestinal tract).

The child is prescribed enzyme preparations that improve digestion ( Mezim, Creon). To restore normal intestinal microflora, the use of probiotics is indicated ( Bifidumbacterin, Hilak).

And to compensate for the lack of vitamins and microelements, a course of vitamin complexes designed for children of a particular age is necessary.

Diet therapy

Diet - one of the fundamental points successful therapy.

Stick to certain rules A child needs nutrition throughout his life.

Yes, from the diet must be excluded products made from wheat, rye, barley, oats (only buckwheat and rice are recommended for cereals), dairy products and whole milk, as well as products prepared on its basis (for example, ice cream), bread, pastries, semi-finished meat products, sausages products, canned food.

Prevention

Any effective ways prevent the development of celiac disease in a child, does not exist.

However, in order to prevent an attack from occurring, the baby must adhere to the principles of a gluten-free diet throughout his life.

Inadolescence and older age are unacceptable bad habits and violation of dietary rules. Moreover, if there is family history(the child’s parents also suffer from this disease), it is necessary to regularly visit specialists with the child for a preventive examination (at least 2 times a year).

This will allow you to identify the problem early stage and start treatment as soon as possible.

Proper nutrition necessary for the successful development of a child. Disorders of the gastrointestinal tract, which include celiac disease, can lead to very serious consequences, such as developmental delays, disability and even death.

Therefore, it is necessary to identify as early as possible this problem and begin appropriate treatment, which consists of taking medications and following the recommended diet and diet.

It is necessary to follow the doctor's instructions throughout the rest of my life, since it is not possible to completely cure this disease.

About the diet for celiac disease in adults and children in this video:

We kindly ask you not to self-medicate. Make an appointment with a doctor!

(celiac enteropathy, non-tropical sprue) is a genetic disease with an autosomal dominant mode of inheritance, which is characterized by morphological, immunological and enzymatic disorders of the mucous membrane of the small intestine and is manifested by intolerance to gluten, one of the components of cereal protein.

The incidence of celiac disease ranges from 1 in 300 people in Ireland to 1.5 in 10,000 in New Zealand. There is a trend towards an increase in the incidence of this pathology from 1.7 per 1000 to 3.5 per 1000 in Sweden, which is explained by the increase in gluten content in children's products.

Causes of celiac disease in children

IN causes of celiac disease genetic predisposition plays a role. These patients have a high frequency of detection of histocompatibility antigens according to the NLA system. The mechanism of development of celiac disease is still not clear enough. There are 2 points of view: 1 - patients with celiac disease lack a specific peptidase, as a result of which gluten and peptides are not hydrolyzed and toxic peptides accumulate in the mucosa; 2 - gluten and its metabolites cause an immunopathological reaction in the intestinal mucosa.

Symptoms of celiac disease in children

The disease has a chronic wavy course. Celiac disease occurs more often in children in the second half of life, 1-2 weeks after the introduction of complementary foods containing gluten. The clinic develops gradually with an increase in anorexia, lethargy, and dyspeptic symptoms.

The child becomes dystrophic, and growth retardation is also typical. Notice the large belly, thin limbs, and muscle hypotonia. The stool is frequent up to 4-6 times a day or more, foamy, acholic, grayish, shiny.

Celiac disease, like all hereditary diseases, is characterized by polymorphism. From the gastrointestinal tract - abdominal pain, possible transient constipation, hepatomegaly and impaired liver function, biliary dyskinesia, damage to the pancreas (pathological amylase curves). On the skin side - itching, atopic dermatitis. Damage to the skeletal system - osteoporosis, pathological fractures, clinic of rickets-like disease. From the outside nervous system- convulsions, tetany, paresthesia, ataxia.

Symptoms of celiac disease in children from the outside endocrine system- insufficiency of adrenal cortex function, low blood pressure, skin hyperpigmentation, polydipsia, polyuria. Disturbances in the blood coagulation system - nosebleeds, gastrointestinal, kidney. Impaired absorption of proteins, vitamins, and microelements leads to hypoproteinemia and edema, ascites, persistent anemia, and impaired twilight vision.

Depending on the predominance of certain syndromes, several clinical forms of celiac disease are distinguished: with bone disorders (rickets-like), edematous, anemic, hemorrhagic, septic and effaced.

Diagnosis of celiac disease in children

Celiac disease is usually combined with disaccharidase deficiency. In the coprogram of patients with celiac disease, the content of fatty acids, soaps, starch, and undigested fiber is increased. Excretion of D-xylose in urine sharply decreases. Radiologically, there is a picture reminiscent of paralytic obstruction - fluid levels in the intestines, combined with a sharp distension of the intestinal loops. The relief of the mucous membrane of the small intestine is blurred, sometimes until the kerkring folds completely disappear. The morphological substrate of celiac disease is flattening of the mucosa, smoothing of the relief, villous atrophy, hyperplasia (elongation) of the crypts, infiltration of the intestinal mucosa with plasmacytes and eosinophils. Intestinal mucosa celiac disease in children damaged by immune mechanisms, as evidenced by the increased content of immunoglobulins E, M, as well as the detection of specific antigliadin antibodies (Ig A) in the blood of patients.

Criteria diagnosis of celiac disease, according to the European Society of Pediatric Gastroenterologists, are: a carefully collected anamnesis, impaired intestinal absorption, changes in the histological picture of the mucous membrane of the small and duodenal intestines, clinical and histological normalization of the intestinal mucosa with a gluten-free diet (no earlier than 6-12 months from the start treatment), relapse of the clinical and histological picture after reintroduction of gluten into food, increased amount of anti-gluten antibodies in the blood.

Treatment of celiac disease in children

Main method treatment of celiac disease in children is a diet with the exclusion of all products containing gluten (flour and cereals - wheat, rye, oats, barley). Fermented milk products, meat, eggs, vegetables (potatoes, carrots), bread products and cereals made from corn, buckwheat, and fruits are allowed.

Celiac disease treatment during an exacerbation - a tea-fasting diet, partial or complete parenteral nutrition in children of the first year of life. This diet is prescribed even if the disease is asymptomatic and must be followed throughout the patient’s life. It must be remembered that even 100 mg of wheat flour taken daily causes pronounced morphological changes in the intestinal mucosa. To increase the amount of protein, you can use protein enpit. In case of exacerbation of the disease, enzymes and vitamins (A.E,B,C,D,K, folic acid) are included in the treatment; according to indications, iron supplements, plasma transfusions, albumin, anabolic hormones, short-course glucocorticoids (10-14 days) .

Celiac disease in children is a hereditary pathology. Another name is Guy-Herter-Heubner disease. The mechanism of its development is explained by gluten intolerance. The substance is a protein, an excess of which is observed in wheat, barley, rye and food products containing it. Gluten irritates the mucous membranes of the gastrointestinal tract and activates the immune system, prompting it to respond by producing antibodies to its own cells. As a result, autoimmune inflammation develops and intestinal tissue is destroyed.

Factors predisposing to celiac disease

The main cause of Guy-Herter-Heubner disease is genetic predisposition. But various pathologies and conditions can also provoke its development, for example:

• defects of the small intestine;
• weak immunity;
• abdominal surgery;
• infection of the body, affecting the villous structure of the intestine;
• diseases of an autoimmune nature - dermatitis, diabetes, rheumatoid arthritis.

Dr. Komarovsky, together with other specialists, puts forward a viral theory of the origin of the disease. The diagnosis of “viral celiac disease” is confirmed by the detection of specific antibodies to the adenovirus in the blood.

Clinical features of celiac disease

The primary symptoms of celiac disease in children do not appear immediately. In infants, they are observed during the period of introducing complementary foods, when gluten-containing products are introduced into the diet. More clear deviations characteristic of the disease are established before the year, at approximately 7–8 months. For some children, the picture of pathology appears closer to their 3rd birthday.

All parents should know the typical symptoms of celiac disease. These include:

1. vomit;
2. swelling;
3. refusal to eat;
4. bloating;
5. signs of rickets;
6. growth retardation;
7. body weight deficiency;
8. lack of teeth;
9. early caries;
10. mood swings;
11. secretion of fetid, foamy, etc.

Atypical symptoms of celiac disease are a number of disorders that are not directly related to the digestive system. These are:

• arthritis;
• anemia;
• dermatosis;
• hair loss;
• dental problems;
• weakness and increased fatigue;
• symptoms inherent in endocrine diseases.

Untimely treatment of celiac disease causes exhaustion of the body and inhibits the development of the child. As you get older, the clinical picture of the disease changes. In children of kindergarten age, celiac disease is accompanied by abdominal pain, nausea and vomiting, and problems with bowel movements. The physical development of a sick child differs from that of his peers.

In adolescence and young adulthood, celiac disease in children develops against the background of a deficiency of vitamins, minerals and various nutrients that the body does not receive. Help to recognize an anomaly:

1. anemia;
2. osteoporosis;
3. short stature;
4. itching and rash on the body;
5. delayed puberty;
6. underdevelopment of tooth enamel.

How is celiac disease diagnosed?

The pediatrician makes the primary diagnosis based on a general examination of the child and refers the patient to a gastroenterologist. Suspicions are confirmed after receiving laboratory and instrumental diagnostic answers. Laboratory research methods include genetic tests, biochemical and general analysis blood, bacteriological, microscopic and biochemical examination of feces.

Among the instrumental ways to diagnose celiac disease are:

• colonoscopy;
• X-ray of the intestine;
• histological analysis of a biopsy taken from the mucous membrane of the tract.

Principles of celiac disease therapy

Treatment for a child with symptoms of celiac disease is varied. The patient is put on a diet, vitamins, enzymes and probiotics are prescribed. Diet therapy involves eliminating foods containing gluten from the diet. In addition to cereals and baked goods, dangerous protein is found in sauces, sausages and dairy products. Children are not allowed to eat ice cream.

Infants are transferred to artificial adapted formulas with hydrolyzed cow's milk protein or soy:

1. Nutri-soy;
2. Frisosoy;
3. Pregestimil.

In case of exacerbation of celiac disease, medicinal mixtures become the basis of children's nutrition. As the condition stabilizes, the diet is gradually enriched with dairy-free, gluten-free cereals, vegetable puree and cottage cheese.

To improve the activity of the digestive glands, enzymes are included in the treatment - Pangrol, Mezim, Creon, Pancreatin. The ratio of harmful and beneficial intestinal flora is corrected with probiotics - Bifiform, Acipol, Laktofiltrum.

Vitamin therapy is aimed at replenishing missing vitamins and microelements. Treatment with multivitamins is developed individually. The child must take the course in spring and autumn. Additional indications for taking vitamins are infectious diseases and vitamin deficiency.

Celiac disease- a disease in which persistent digestive upset occurs caused by a violation of the absorption process in the small intestine of carbohydrates and fats due to intolerance to gluten (gliadin) - the gluten protein of some cereals: wheat, oats, rye, barley.

information Patients are diagnosed with insufficiency of the enzymatic systems of cells in the intestines, which are involved in the breakdown of the gluten peptide. At the same time, the human body produces antibodies against gliadin.

Celiac disease usually develops in children two to three years old. Symptoms of the disease are almost invisible at first, but then the disease progresses, the child begins to lose weight and lag behind his peers in height. In some cases, the first signs of a disorder can be noticed even in infants who are intolerant to cow's milk.

Modern research has established that 0.5-1% of the entire population is prone to developing celiac disease, which is millions of people throughout the planet.

Causes

The exact causes of celiac disease in children have so far been definitively not installed. There are the following versions of the origin of this disease:

• hereditary predisposition- the main suspected cause of the disease. Scientists believe that gluten intolerance occurs due to damage to the human genes that are responsible for susceptibility to this substance;
• autoimmune theory- it is assumed that persistent irritation of the intestinal walls occurs due to the effects of protein breakdown products from cereals. Damaged cells are attacked by the human immune system;
• virus theory: arose due to the fact that antibodies to certain types of adenoviral infection (for example, to “stomach flu”) were found in the blood of patients.

Symptoms of celiac disease in children

Children with celiac disease experience the following: symptoms:

• loss of appetite, insufficient weight gain;
• increased weakness, fatigue;
• pale skin;
• anemia ( low level hemoglobin), muscle hypotonia;
• increased abdominal size - observed due to flatulence and increased fluid content in the intestinal loops;
• growth retardation: in the absence of treatment, the height of girls may not exceed 155 cm, and for boys - 165 cm;
• prolonged diarrhea (diarrhea);
• nausea, vomiting;
• delayed sexual development: absence of menstruation in girls under 15 years of age, insufficient development of the mammary glands;
• dermatitis herpetiformis - the appearance of a rash on the skin in the form of blisters or spots, severe itching of the affected areas;
• osteoporosis - increased fragility of bones: occurs in 50% of children suffering from celiac disease. The disease occurs due to a disruption in the absorption of minerals in the digestive tract in celiac disease.

After eliminating foods containing gluten from a child's diet, bone density is restored to normal levels. within one year.

Diagnostics

The diagnosis of celiac disease can be confirmed using the following methods:

• coprogram - with the help of this study you can determine the level of fatty acids in the feces;
• blood chemistry ;
• intestinal colonoscopy;
• X-ray of bones - performed to determine bone density;
• analysis of biopsy samples of the small intestinal mucosa.

In addition, in order to finally establish the analysis, the doctor may recommend that parents exclude foods that containing gluten, from the child’s diet, for several days. If after two or three days the baby’s condition improves significantly and the unpleasant symptoms from the digestive system disappear, then cereal protein intolerance really exists.

Treatment of celiac disease in a child

The main treatment for celiac disease in children is complete eliminating foods from the diet that contain gluten. Such grain crops are wheat, oats, rye and barley.

additionally Please be aware that some prepared products (e.g. tomato sauce) offered by the food industry may contain small amounts of wheat flour, and even a small amount of gluten-containing foods can be harmful to the baby. Therefore, when purchasing food products, it is necessary to carefully study the composition of the ingredients on the packaging.

Instead of wheat or rye bread include in the child's diet bakery products from rice, buckwheat, corn or soy flour. Unfortunately, it is not possible to find it on sale in all localities. similar products- in this case you will have to prepare gluten-free food on one's own.

In addition to following a gluten-free diet, the following methods are used in the treatment of celiac disease:

• restriction in the diet of fatty foods;
• prescription of vitamins;
• additional intake of drugs containing enzymes and minerals: pancreatin, methionine, calcium glycerophosphate, enteroseptol - this helps to normalize the digestion process and replenish the deficiency of minerals in the body;
• prescribing probiotics- medications that help restore intestinal microflora.

information Don't assume that a gluten-free diet means eating tasteless foods. The diet can include sufficient quantities of potatoes, rice, corn flour products, honey, fruits, vegetables, milk, low-fat cottage cheese, fish, and meat.

Among fats, preference should be given to foods plant origin.

Complications

If not detected in time illness and lack of treatment in children, such serious disorders as significant growth retardation, a tendency to bone fractures, arthritis, anemia, and decreased immunity occur.

Subject to following a gluten-free diet, the appearance of the above complications can be avoided.

Prevention of celiac disease

Unfortunately, It is not possible to prevent the onset of celiac disease, since this disease develops under the influence of a hereditary factor or under the influence of autoimmune disorders.

Preventive measures can only consist of constant monitoring of the baby's health in order to timely detect suspicious symptoms, which will avoid the occurrence of serious digestive disorders and metabolic disorders.

Consequences

If your child is diagnosed with celiac disease, they will need to follow a gluten-free diet. throughout life. Even 10-20 years ago this was quite difficult, but nowadays the food industry offers a large range of gluten-free food products. If such goods are not available in trading establishments of one or another settlement, you can order them online or prepare the food yourself. The main thing in the treatment of celiac disease is to prevent your child from eating prohibited foods, even occasionally, so as not to provoke an exacerbation of the disease.

Celiac disease or celiac disease is an allergic disease in which the intestines cannot accept and absorb foods containing gluten. Celiac disease is considered a congenital disease that is transmitted from parents to child, but the mechanisms of development of the disease have not yet been fully elucidated.

With celiac disease, gluten entering the intestines is not completely broken down, and as a result of incomplete breakdown, toxic substances are formed that injure the inner surface of the intestine. In young children, celiac disease begins to develop with the introduction of complementary foods, which parents can determine by: vomiting, foamy stools, worsening weight gain, and bloating.

In the adult population, celiac disease is disguised as diseases of the intestines and stomach, which are chronic. In such cases, the patient can unsuccessfully treat unstable stools, flatulence and other diseases associated with dyspepsia for a long time, unaware of gluten intolerance.

That is why official statistics are significantly underestimated and represent a percentage of cases equal to 1:1000. It is also widely believed that celiac disease is not a disease, but a lifestyle that requires diet, because without contact with gluten, the development of celiac disease is impossible. The most toxic part of broken down gluten is gliadin (the alcohol soluble fraction).

Interesting facts about the disease

Celiac disease began to exist from the moment humans began to eat cereals (rye, wheat), so the age of the disease goes back several thousand years.

Women are more susceptible to the development of celiac disease, and it practically does not occur in Africans, Japanese and Chinese. Most likely, this is due to dietary habits or a genetic component.

Some regions of Russia still do not recognize celiac disease as a pathology, and doctors are prohibited from making such a diagnosis.

Some experts classify celiac disease as a precancerous condition, which increases the risk of developing digestive cancer, small intestinal lymphoma, and intestinal bleeding.

If parents suffer from celiac disease, the risk that the child will have this pathology after birth is 1:10.

Causes

The exact causes of celiac disease are still unknown, but there are several theories about the occurrence of this disease. The most common are immunological and enzymatic, with the first being supported by most researchers.

Immunological

Autoimmune antibodies to the cell structures of the intestinal lining and antibodies to gluten appear in the blood. In the presence of celiac disease, the number of intraepithelial lymphocytes with a specific set of receptors is increased. It is these cells that mistakenly identify gluten as a threat and damage the intestinal walls.

Enzymatic

The small intestine lacks the enzyme that breaks down gluten. This is quite probable cause, but has not been fully proven for the reason that following a diet leads to the restoration of intestinal enzymatic function.

• Viral theory

According to research by scientists, about 90% of patients with celiac disease have an increased number of antibodies to a certain type of adenovirus. However, you should not believe your doctor if he says that celiac disease is caused by an adenovirus. It has nothing to do with a congenital disease; gluten is simply antigenically similar to an adenovirus.

Pathoreceptor

It is based on the assertion that the intestines have an abnormal protein composition, which leads to excessive sensitivity of the small intestine to gluten.

Most scientists agree that the proposed picture of gluten intolerance includes all theories and unites them: there is no enzyme - gluten is not broken down and accumulates, which leads to a toxic effect on the intestines, which responds by reacting cells with special receptors. Such cells perceive gluten as a threat and attempts to destroy it lead to damage to the intestinal walls, which disrupt the process of digestion and absorption of food. In this interpretation, an adenovirus is considered a possible initiator of the body’s immune response to gluten.

Symptoms

In the medical literature, three forms of clinical manifestation of celiac disease are distinguished. The real picture of the disease has a variety of manifestations: celiac disease can masquerade as various diseases Gastrointestinal tract, dermatological pathologies, hypovitaminosis and others. It is due to the variety of symptoms that celiac disease is diagnosed in a limited number of patients, while a larger number of patients with celiac disease continue to be treated for false, but similar in symptoms, diseases.

At the same time, there are cases when all tests and clinical manifestations confirm the presence of celiac disease in a patient, but after a biopsy of the small intestine, the doctors’ diagnosis is not confirmed.

It is also worth noting that the earlier foods containing gluten are introduced into food and the more of them there are, the faster celiac disease will begin to develop, and the nature of the course of the disease will be much more complex.

Symptoms of celiac disease in children

The typical form of celiac disease is characterized by three striking symptoms:

Frequent stool (5 or more times a day), while it has a mushy consistency, smells bad, foams, has different colors, shiny inclusions of fat, is difficult to wash off and there is quite a lot of it.

Protruding belly. Parents think that this is because the child eats well; the doctor may say that the reason is the child’s development of rickets.

Presence of retardation in weight and height. Particularly noticeable is the lag in weight in the first two years of life and a noticeable lag in growth after reaching the age of two. In this case, a lack of weight gain begins to be observed after the introduction of complementary feeding, although before complementary feeding, weight gain occurred at a normal pace.

Other symptoms that confirm the presence of celiac disease in a child are associated with a lack of nutrients, microelements, and vitamins. For each specific case it may be different:

Lethargy, fatigue or, conversely, increased irritability, aggressive behavior, tearfulness.

Unsatisfactory condition of the skin and hair: atopic dermatitis, flaking of the skin, dryness, weakness.

The child is susceptible to frequent fractures at the slightest opportunity. It should be borne in mind that a healthy child’s bones are much stronger than those of adults due to their elasticity.

Insufficient muscle tone (hypotonia).

Incorrect posture.

• The appearance of oral cavity pathologies: stomatitis, caries, enamel fragility, bleeding gums.

  The child has a characteristic – unhappy appearance.

  The child has thin limbs and a large belly, which is why such children are compared to spiders.

As a child with celiac disease grows up, disturbances in the functioning of the reproductive system are observed: in boys - sexual dysfunction, in girls - absence of menstruation.

Symptoms of celiac disease in adults

The symptoms of celiac disease in the adult population are characterized by a latent and atypical form. The manifestation of an atypical form is possible only after 30-40 years of life. This form of the disease is characterized by the presence of one of the main symptoms of the typical form of the disease and several accompanying ones. In general, extraintestinal manifestations of the disease come to the fore:

Dermatological: atopic and herpetiform dermatitis.

Neurological: depression, migraine.

Reproductive: infertility.

Joint: pain in the joints, the cause of which cannot be explained, arthritis.

Renal: nephropathy.

Changes in biochemical blood test: increase in albumin, transaminases, alkaline phosphatase, decrease in cholesterol.

Clinical studies have shown that 4-8% of women who have undergone infertility treatment without success suffer from celiac disease. After introducing a gluten-free diet, they were all able to give birth to a child.

The latent form of the disease may not manifest itself in any way, except for irregular intestinal problems or skin problems (dermatitis), which no one can associate with the disease. Therefore, celiac disease is detected only through random examination.

Complications that occur with gluten intolerance

A long-term course of the disease in a latent form leads to an increased risk of developing serious diseases:

Autoimmune hepatitis, autoimmune thyroiditis.

Type 1 diabetes mellitus.

Rheumatoid arthritis.

Oncology of the gastrointestinal tract.

Recurrent pericarditis.

Scleroderma, myasthenia.

Diagnosis of the disease

In most cases, celiac disease is detected during a comprehensive diagnosis of the body in the process of confirming the diagnosis of one of the diseases listed above. Targeted diagnosis of celiac disease includes three stages:

The first is an immunological test of the patient’s blood. During the study, the presence of tissue transaglutaminase, autoimmune bodies to reticulin, endomysium, and the level of antigliadin antibodies are determined.

The second - if the first stage has positive test results, then a biopsy of the small intestinal mucosa is performed, which includes determining the presence of lymphocytes with atypical receptors, inflammation, and the general condition of the villi. The second stage is the most important for making a correct diagnosis.

The third is prescribing a gluten-free diet and observing the patient with a doctor for 6 months. If the general condition improves, a reverse development of the symptoms of the disease is observed - the diagnosis is 100% confirmed.

The peculiarity of the treatment is that even with negative biopsy results, the patient with positive immunological tests is assigned the third stage of diagnosis. If the patient’s condition improves within six months, the diagnosis of celiac disease is confirmed, and this form of the disease is called potential.

A repeat immunological examination is carried out a year later, and positive dynamics are expected. After two years, a repeat biopsy should confirm complete restoration of the small intestinal villi.

Differential diagnosis

Doctors are usually in no hurry to diagnose celiac disease, much less prescribe an intestinal biopsy. Initially, celiac disease must be distinguished from hereditary intestinal diseases, intestinal infections, immunodeficiencies, and food allergies.

Celiac disease differs from the listed pathologies due to the good effect of following a gluten-free diet (prescribed in case of a positive response to an immunological examination of atypical antibodies), and the absence of blood and mucus in the stool.

Treatment

Lifelong adherence to a gluten-free diet is the only effective way treatment. A typical diet for celiac disease involves the exclusion of baked goods, confectionery products, cheap sausages, sausages, cutlets, sauces, some cereals (semolina, pearl barley, oatmeal), and pasta. Also gluten in hidden form may be contained in beer, kvass, malt extract, dyes, coffee, cocoa, canned food, ice cream, cottage cheese and yoghurt, curd cheese, ketchup, mayonnaise.

Critical for an allergy sufferer is the content of more than 1 milligram of gluten per 100 grams of product.

Permitted for use:

Natural dairy products, eggs.

• Fish, meat.

  Fruits vegetables.

  Millet, corn, buckwheat.

  Marmalade, chocolate.

For children, special mixtures are prescribed that contain soy or casein hydrolysate. To introduce dietary complementary foods, special gluten-free cereals are used. Once a diagnosis has been made, therapy is limited to reducing symptoms:

Improving digestion with the help of pancreatic enzymes (Pancreatin, Creon).

Correction of intestinal microflora: prebiotics (Hilak Forte), probiotics (Actimel, Linex, Bifiform), intestinal antiseptics (Enterofuril).

Treatment of diarrhea: Imodium, Smecta, oak bark decoction.

Treatment of bloating: Plantex, Espumisan.

Therapy for hypovitaminosis: vitamins K, D, E, B, A, nicotinic acid (in severe cases), multivitamins orally are administered intravenously.

Treatment of malnutrition: increasing calorie intake, nutrition correction.

Elimination of protein deficiency: albumin, mixtures of amino acids.

Correction of water-electrolytic balance: calcium gluconate, Panangin.

Treatment of autoimmune diseases with glucocorticosteroids.

The patient undergoes simultaneous therapy for celiac disease and monitoring for concomitant diseases, for example, diabetes.

Under no circumstances should you accept medications(pills and tablets) the shell of which contains gluten (for example: Festal, Mezim Forte, Complivit). It is also worth paying attention to the composition of liquid preparations and excluding preparations containing malt (Novo-passit), which is contraindicated for use by patients with celiac disease.

Celiac disease is not a death sentence

Most children, when the diagnosis of celiac disease is confirmed, become disabled, but in the case of strict adherence to a properly designed diet, the prognosis is quite favorable. After a few weeks, the intestinal symptoms of the disease go away, and during the first couple of months the protein, water-electrolyte, vitamin-mineral balance is completely restored.

A child who follows all the points of treatment for the disease is able to catch up with his peers in height and weight. However, adherence to a gluten-free diet should be carried out for life, because poor nutrition, and with it the progression of the disease, can lead to the development oncological diseases Gastrointestinal tract and the return of all pathological phenomena.