People who are susceptible to celiac disease - children

With the continuous improvement of living conditions today, children have become the top priority of families. Childhood obesity and overnutrition have become problems that must be faced, and they frequently appear on television, the Internet, and newspapers. But when it comes to growth retardation and malnutrition, everyone might think that it was something that only happened in poor areas a long time ago. However, children's developmental delay is not entirely due to malnutrition caused by picky eating and anorexia, but may also be caused by non-nutritional factors. Among them, celiac disease is a non-nutritional disease that is often overlooked. Celiac disease is also known as gluten-sensitive enteropathy. In the past, due to unknown etiology, it was also called idiopathic malabsorption syndrome. Children have become the most vulnerable group among celiac disease patients.

The findings were published online April 21 in the journal JAMA Pediatrics. Screening should focus on children with IBS rather than those reporting recurrent abdominal pain, according to results from a prospective study. Children with irritable bowel syndrome (IBS) are more than four times more likely to have celiac disease than the general population.

Celiac disease is a sensitivity to foods containing gluten, a substance found in cereals. In people with a genetic predisposition, exposure to foods containing gluten triggers an immune response that can lead to damage to the intestinal lining, abdominal pain, changes in bowel habits, malnutrition, and a host of other symptoms including anemia and neurological problems. People with this disease cannot eat foods containing wheat, rye or barley, which are the main sources of protein in the Western diet.

Previous studies in adults have shown a strong association between celiac disease and IBS, but little data is available for children.

Professor Fernanda Cristofori from the University of Bari in Italy and colleagues point out that recurrent abdominal pain affects 10-15% of school-age children, accounts for more than 50% of pediatric gastrointestinal morbidities, and 2% to 4% of all pediatric outpatient visits.

To assess the prevalence of celiac disease in children with recurrent abdominal pain, the researchers examined 782 children presenting with abdominal pain or a pain-related disorder: 270 children with IBS, 207 with functional dyspepsia, and 311 with functional abdominal pain.

This prospective observational study was conducted between 2006 and 2012 at the University Hospital of Bari, a tertiary referral center for gastrointestinal diseases in the region. We used serum testing for immunoglobulin A, anti-tissue transglutaminase, and endomysial antibodies as initial screening for celiac disease, and confirmed the diagnosis with upper endoscopy, which included multiple duodenal biopsies.

Fifteen patients tested positive for celiac disease: 12 (4.4%; 95% confidence interval [CI], 2.5%-7.6%) children with IBS, 2 (1.0%; 95% CI, 0.2%-3.5%) with functional dyspepsia, and 1 (0.3%; 95% CI, 0.1%-1.7%) with functional abdominal pain.

Given the relatively high false-positive rates of blood tests in the general pediatric population, the researchers suggest that pediatricians should weigh the possible benefits and risks of screening, including endoscopy, while also considering environmental factors when deciding on screening.

The reason why children are susceptible to celiac disease is that their parents are afraid that their children are not getting enough nutrition and unscientifically restrict their children's diet, which causes the disease to occur prematurely. Parents should pay attention to letting their children eat less gluten-containing foods such as wheat, eat a balanced diet, and pay attention to their children's growth and development. Prevention is the key to keep your children away from celiac disease!