Gluten allergy, or celiac disease, affects 1 in 133 people. It is a genetic disorder that affects some people without any outward symptoms. Having a parent or sibling with the disease increases the odds that a child will be born with the inability to metabolize gluten. Children with a close relative with celiac disease should be screened whether they exhibit symptoms or not. Children with symptoms can be diagnosed as soon as symptoms appear, usually when they begin to eat solid foods containing gluten around 4 to 6 months of age.
Celiac Disease
Individuals with celiac disease have an inappropriate autoimmune response to the protein in wheat, rye and barley. When gluten protein is ingested, the immune system attacks the villi in the small intestine. Villi are small protrusions that absorb nutrients from food. Without them, a person can become malnourished even though they eat plenty of food. Celiac disease is often diagnosed when a young child fails to thrive.
Diagnosing Gluten Allergy
Gluten allergy, or celiac disease, can be diagnosed in one of two ways in young children. If parents or the pediatrician suspect celiac disease, the doctor may order a blood test to screen for abnormally high levels of anti-tissue transglutaminase antibodies or anti-endomysium antibodies. The blood test is usually confirmed by a biopsy of the small intestine.
If the blood tests are negative but the child's symptoms cannot be explained in any other way, the pediatrician may suggest an elimination diet. In this case, parents remove all sources of gluten from the child's diet and keep a detailed symptom log to see if removing gluten improves the child's symptoms.
Misdiagnoses in Young Children
Blood tests can be an inaccurate test for celiac disease, especially in young children, because several factors can falsely lower the number of antibodies in the blood. One factor is immune system immaturity. An immature immune system simply does not produce some of the antibodies doctors can look for in a blood test. A gluten-free diet also can produce a false negative. If there is no gluten in the child's digestive system, the child's body will not produce antibodies. If blood tests for celiac disease are negative, a biopsy is often the best way to diagnose young children.
Treating Gluten Allergy
The only way to treat a gluten allergy is avoidance. Your child's pediatrician can help you find a qualified dietitian who will work with you to create a well-balanced, gluten-free diet. Your child will have to follow a gluten-free diet for life. Gluten-free alternatives are becoming more prevalent in mainstream grocery stores, which makes following this diet easier.
