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Baby and childhood digestive system disorders: coeliac disease BABY AND CHILDHOOD DIGESTIVE SYSTEM DISORDERS: COELIAC DISEASE
This is a disease affecting infants and children. It may start to produce symptoms soon after weaning when the infant is introduced to solids. It affects one in 4000, and often there is a family tendency.
The disease affects the small bowel. Frequent and loose bowel actions, general debility, a failure to thrive and a pot belly in children are the usual symptoms. Many become irritable and peevish for no obvious reasons.
The cause is an allergy to the gliadin fraction of gluten. Gluten is the protein part of wheat and certain other grains. In this disease the cells of the jejunum, the first part of the small bowel, are sensitive to gluten and simply cease to function normally. Diagnosis is often overlooked for many years. The fact that the infant does not thrive as well as other members of the family may be accepted without proper medical investigation. A diagnosis is firmly established when a biopsy of the jujenum is performed and the diseased cells examined under the microscope. In 1977 a simple test was invented which consists of a simple injection of the skin. This is much quicker, but it has not yet become generally available.
Treatment
Once an accurate diagnosis has been made, treatment is usually dramatic in its beneficial effects. The patient is placed on a gluten-free diet. Symptoms vanish like magic, often within a few days. A feeling of well-being commences almost immediately. But it may take many months, even up to a year, for the full benefits to become evident. As symptoms have often been present for a long time, reversal and a total cure may be time-consuming. Between 80 and 90 per cent of patients improve dramatically on this simple routine.
Today, Coeliac Societies exist in many countries, and membership is an excellent idea. Recipes for making gluten-free products are made available, and helpful advice offered. Also, lists of commercially available items are regularly mailed to members, allowing them wider selection in foods if they wish to purchase them. In Australia, the address is: The Coeliac Society, P.O. Box 73, Cronulla, N.S.W. 2230.
Parents soon become proficient at making gluten-free bread and other food items. Often this may be conveniently made on a weekly basis, and deep frozen until needed. Once the routine has been commenced, it is usually no great domestic burden, and most parents are only too happy to have discovered a way of helping their child, and seeing the symptoms disappear. The stress and anxiety of caring for a perpetually ill and undernourished child far outweighs any extra work in preparing a gluten-free diet.
Symptoms suggesting coeliac disease should never be dismissed or neglected. Referral to a paediatric physician is usually necessary, so that adequate investigation and treatment can be carried out.
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