What is celiac disease?

It is a disease that occurs when foods containing wheat, barley, and rye are consumed by people with a hereditary predisposition. The main substance that causes problems in celiac patients is a protein called gluten, which is found in the cereals I mentioned above. Symptoms of the disease usually appear after the age of 2, but the disease is also seen in adults.

What are the symptoms of celiac disease in children?

• Abdominal pain and diarrhea; abdominal swelling; anemia (iron deficiency, B12 deficiency, folic acid deficiency); weakness and fatigue.

• Inability to gain or lose weight;

• Growth retardation;

• Delay in puberty;

• Constipation.

Some blood tests can be helpful for people with symptoms of the disease. However, intestinal biopsies taken by endoscopy should be examined under a microscope for a definitive diagnosis. Since celiac disease cannot be diagnosed based on blood test results, it is wrong and inconvenient to start diet therapy based on test results. The treatment for the disease is a lifelong gluten-free diet. Care should be taken as the disease is more common in children of the same family at preschool or school age. If parents or siblings have celiac disease, other siblings should be screened with a blood test.

At what age does celiac disease occur?

Celiac disease can occur at any age after starting grain feeding.

Why is it early in some, late in others, obvious in some, ambiguous in others?

We don't know. most likely due to environmental reasons. It usually occurs around 2 years of age, after 18 months of age. What symptoms does celiac disease present with?

There are 4 forms of the disease: the classical form, the late form, the atypical form, and the silent form.

Classical form: With the addition of gluten-containing foods to the diet, it is seen with symptoms such as vomiting, fatty diarrhea, an inability to gain weight, and abdominal distension. As the patient's age progresses, abdominal distension and fatty stools increase. Abdominal pain, anemia due to iron deficiency, growth retardation, and the inability to gain weight are common findings.

Late form: It is usually symptomatic. But its onset in adulthood is not an exception. It is associated with developmental delay. Abdominal swelling and diarrhea are not evident in these. In addition, one or more of the following symptoms and signs may be present:

Atypical celiac disease: Celiac disease can present symptoms without classical findings (diarrhea, abdominal swelling). These symptoms can also occur in older adults.

Silent celiacs are patients who are found to be positive when family members of someone diagnosed with celiac disease are tested by blood test but have no obvious complaint. Since the risk of developing celiac disease in first-degree relatives (parents, siblings) is higher than in the general population (1:100 in the community, 1:10 in first-degree relatives), even if these people do not have a complaint, they should be screened by blood tests.

Deniz ERTEM, M.D. Prof.

Pediatric Gastroenterology