Natural Pediatrics

Celiac Disease, also known as Celiac Sprue, is caused when the body recognizes gluten (found in wheat, rye, spelt, barley, and other grains) as a toxic substance and eventually results in changes to the intestinal tract, making it more difficult to properly absorb nutrients. Common digestive symptoms include abdominal pain/cramping, diarrhea, constipation, pale stools, bloating, and decreased appetite. Besides the digestive symptoms associated with Celiac Disease, the latest research indicates that a number of people may have other manifestations of the disease that present before the changes to the gut are detectable. These symptoms include depression/irritability (presenting as behavior problems in children), rashes, sores in the mouth, muscle pain,  joint pain, tingling/numbness in extremities, fatigue, weight-loss or difficulty gaining weight, stunted growth, and rash.

Why should you be concerned even if your child has only one of the symptoms listed above?

Celiac Disease is far more prevalent than we once thought. Currently, only about 10% of those affected are accurately diagnosed. That means 9 out of 10 people who have the disease have not been diagnosed. The prevalence is thought to be as high as 1 in 133 people in the United States. Those with European ancestry may be at greater risk and those who have a primary relative (mom, dad, or sibling) with Celiac have a 1 in 8 chance of having the disease. Other risk factors include Type I Diabetes, Thyroid Disease, Down Syndrome, Psoriasis, and several Auto-immune diseases.

What is the treatment for Celiac disease?

Treatment involves strict adherence to a gluten-free diet. Some pediatricians may be hesitant to test children who do not present with the typical digestive symptoms. This is largely due to their own reservations about recommending a lifelong gluten-free diet as the only known treatment. Since close to 40% of people with Celiac disease may have no obvious (digestive) symptoms, it is worth pursuing if you think your child may be at risk (or has some of the other manifestations).

Is Celiac Disease really that harmful, even if it isn’t causing my child obvious symptoms?

Yes! Besides some of the uncomfortable and embarrassing symptoms that some may develop, Celiac Disease is associated with increased mortality and increased risk of a variety of serious health problems. The list of associated conditions ranges from osteoporosis to several types of cancer. The good news is that sticking to a gluten-free diet can reverse the increased risk for many of the conditions associated with Celiac Disease.

Is it realistic to expect children to stick to a gluten-free diet?

Gluten free eating has gotten much easier with a greater prevalence of gluten-free foods and resources available. Children are generally quick to respond to dietary changes and positive results can usually be seen in 3-6 weeks of a gluten-free diet (compared with adults who may need to be gluten-free for 3-12 months to see similar results). In my practice, parents are generally more anxious about removing foods from their child’s diet than the child. Many times, even if the child is initially resistant to the change, they will feel so much better that they will be the ones checking to make sure everything is “safe” for them to eat (even children as young as 2 and 3). You should consider taking your child to a Naturopathic Doctor for additional recommendations on nutritional supplements that may be beneficial in addition to the gluten-free diet.

 If you need support, you should ask your child’s health-care provider about seeing a Nutrition Therapist or Registered Dietitian with experience counseling patients with Celiac Disease. You may even be able to find a local support group, where you can get more resources and support from other parents and families following the gluten-free lifestyle.

Where can I get more information?

Here are some great websites and resources for people with Celiac Disease or who want more information about eating gluten-free (some people feel better on a gluten-free diet even if they don’t have Celiac Disease).

Resources/Recipes:

www.celiac.com

www.csaceliacs.org

www.celiac.org

www.glutenfreeda.com

Gluten-Free Recipe Blogs:

www.nourishingmeals.com

www.glutenfreegoddess.blogspot.com

www.glutenfreemommy.com

www.glutenfreegirl.com

If you have any other favorite gluten free resources or recipes, please comment and I will make sure it gets posted!

About the Author:Dr. Bowker is a Naturopathic Physician and owner of Snohomish Valley Holistic Medicine. In addition to her clinical practice, Dr. Bowker serves as a Board member for the Washington Association of Naturopathic Physicians. She has also been a guest speaker for community organizations and instructor of several community health classes. For more information, please visit her primary website: www.snovalleyholistic.com