Advancing Children's Health

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Is gluten-free for me?

Published by , on Feb 7, 2014

boy with orangesWith numerous products now labeled “gluten-free,” many parents may be wondering whether gluten is something to consider when selecting food for their families or if it’s just another passing fad. Dr. Martin Graham, Division of Gastroenterology and Nutrition, gives us an inside look into gluten and the medical condition it often relates to, celiac disease.What is gluten?Gluten is a protein found in wheat, barley and rye, but not in oats, rice and corn. Though the positive effect of eliminating gluten from the diets of individuals with celiac disease was first noted in the 1950’s, the term “gluten-free” has become more common in recent years as regulations now require wheat and other common food allergens be identified on food labels.What is celiac disease?Celiac disease is a complex genetic disease affecting more than 2 million people in the United States (about 1 in 133 people).* The disease is caused by the presence of gluten in the diet and though symptoms may come and go, individuals with the disease will have it throughout their life. The critical component of gluten is a protein called alpha-gliadin. More than 95 percent of patients with celiac disease have one of two genes that react with alpha-gliadin. These genes are found in 50 percent of people in the United States and Europe, but only 10 percent of people with these gene types are affected by celiac disease. Children are at higher risk for celiac disease if they have:

  • Type 1 diabetes
  • Autoimmune thyroid disease
  • Dermatitis herpetiformis
  • Down syndrome
  • Turner syndrome
  • Williams syndrome
  • A relative with celiac disease

What are the symptoms?Much like with an allergy, it’s an accident of nature that the alpha-gliadin in wheat reacts with the genes. This immune system response leads to inflammation in the intestinal wall which can flatten the finger-like projections lining the small intestine known as “the villi.” When this occurs, the intestine can no longer absorb food adequately, leading to the following symptoms:

  • Diarrhea
  • Weight loss
  • Cramping
  • Poor growth
  • Abdominal pain
  • Anemia (a decrease in red blood cells)

Those experiencing symptoms may feel tired and irritable and have a skin rash or mouth sores. Symptoms can occur gradually or begin suddenly (often during times of stress) and can vary in intensity from week to week. Symptoms of celiac disease are often mistaken for other digestive issues.How is celiac disease diagnosed?If you are concerned your child might have celiac disease, either because of symptoms, family history or juvenile-onset diabetes, ask your child’s doctor to perform a screening blood test. For the test to be accurate, the child should have been on a gluten-containing diet for at least six weeks prior to the screening test. If the screening test is positive, a definitive diagnosis can be made only by endoscopy (visual exam of the intestine with a scope) and biopsy, typically performed by a pediatric gastroenterologist. These tests can demonstrate the inflammation and flattened villi described above. It is important to make a definitive diagnosis by biopsy because the individual will need to be placed on a gluten-free diet for life.How do you treat it?Celiac disease is cured by eliminating gluten from the diet. A gluten-free diet should be explained by a dietitian to address the nutritional concerns of eliminating or replacing certain foods. This specialized diet is made relatively easy by the numerous gluten-free products on the market.It turns out, “gluten-free” isn’t just a fad! Though many American are going gluten-free for a variety of reasons, there is often a health need to do so. If you notice your child is having digestive issues, speak to your pediatrician about potential causes, like celiac disease. A simple change to a gluten-free diet could make all the difference.Has your family gone gluten-free for any reason? Share your tips or favorite gluten-free recipes in the comments!*Statistics from the National Institutes of Health

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