@$ID/[No paragraph style]:Recently some parents have been asking me a mouthful of questions about celiac disease, which means their child is unable to tolerate gluten in the diet. Let me see if I can help them — and you — digest some information on gluten and this disorder.

Gluten is the term used for a group of proteins found in grains like wheat, rye and barley; after sugar, it is the second-most consumed ingredient in our diet.

If a child develops an allergic reaction to gluten (for reasons that we still don’t understand), that reaction damages the small intestine and makes it difficult for the body to absorb not just gluten but other vitamins and minerals needed to stay healthy. This can result in malnutrition, anemia and even an increased association with other diseases like thyroid disease and diabetes.

This inability of the body to absorb nutrients due to gluten is called celiac disease.

Celiac disease can run in families and affects people of all heritages, although it is most common among people of northern European descent. It is estimated that one in about 130 people has some form of celiac disease, but the difficulty in absorbing nutrients can be so mild that many of us never know we have it.

Common symptoms can include diarrhea, abdominal pain and bloating, weight loss and fatigue — which might also occur with other digestive disorders.

If you are worried about your child possibly having celiac disease, talk to your child’s doctor, who can do a blood test and if necessary refer your child to a pediatric digestive specialist who can do further tests to confirm the diagnosis.

Treatment involves a diet free of gluten for the rest of your child’s life, so it is very important to be sure that celiac disease is really the cause of your child’s abdominal symptoms or poor growth.

If celiac disease is diagnosed, your child’s doctor or a dietitian can help you adjust the diet appropriately. Pay careful attention to food labels to make sure products do not contain gluten. Foods made with corn flour, rice, meat, fish, chicken, dairy products, fruits and vegetables do not contain gluten, so don’t despair that your child will starve. They now even make gluten-free bread.

Hopefully tips like these will seal the deal when it comes to knowing more about gluten and celiac disease.



Dr. Lewis First is chief of pediatrics at Vermont Children’s Hospital at Fletcher Allen Health Care and chairman of the Department of Pediatrics at the University of Vermont College of Medicine. For archives or to submit a question, visit www.FletcherAllen.org/firstwithkids.