Coeliac disease in children:
A coeliac disorder can manifest itself at any age. In children it usually becomes evident three to five months after commencing eating gluten-containing foods. In the worst cases, the infant will refuse his feeds, stop putting on weight, become irritable, or listless and develop a large abdomen. Stools become abnormal, either large, pale and offensive or developing into diarrhoea.
In other cases, no symptoms are shown until later in childhood when lack of growth and poor appetite become evident. Tests will indicate excess fat in stools and lack of protein and iron in the blood. A possible diagnosis can be established by passing a tube through the mouth into the upper part of the small intestine and obtaining a tiny piece of its mucosa lining. Examination under a microscope can sometimes show whether degeneration of the villi has taken place.
It has been found in recent years that this procedure does not always show the existence of coeliac disease, leading to conjecture that gluten/wheat intolerance may be far more prevalent than has been traditionally accepted. Therefore, irrespective of the result, a biopsy should be further verified by the use of a low carbohydrate, grain and gluten-free diet, for one or two months. An improvement in health will verify the existence of coeliac disease. Once this disease has been established, the removal of all gluten-containing foods from the diet will ensure a swift recovery. In addition, it may be necessary to restrict fats and sugars for a month or two, until the villi have begun to recover. Full recovery should take place after two to twelve months on a gluten-free diet. Once recovery is advanced, many allergy-type symptoms will disappear as the intestine loses its sensitivity to previously untolerated foods.
It is absolutely essential that a gluten-free diet be maintained permanently. Teenagers, who have been on a gluten-free diet for a number of years, may feel well enough to commence eating normal flour products again. This is a serious mistake and will eventually lead to a breakdown in health caused by renewed damage to the small intestine, and resulting in slowly increasing malabsorption of essential nutrients (vitamins, minerals and amino acids). It may be one or two years before actual symptoms are again experienced, but eventually, unless the gluten-free diet is resumed, chronic illness and stoppage of growth will result.
Coeliac disease in adults:
Unfortunately, coeliac disease in adults is neither as easily recognizable nor as quickly recovered from, as in children. Usually it is a less obvious form of the disease which was not apparent during childhood. Even so, the person concerned may have been quite sick since early infancy. Usually such a person either has a history of chronic illnesses which he or she was expected to ‘grow out of’, or is underdeveloped to some degree, with a tendency towards lethargy and depression.
Because of the time span, coeliac disease, diagnosed in adulthood, will usually have resulted in a greater degree of damage to the small intestine than that occurring in childhood. Some adult coeliacs will only partly respond to a gluten-free diet, due to extensive damage to the small intestine over such a long period. In these cases, almost 5 per cent, corticosteroids have been used with some success. In the great majority of cases however, rigid abstention from grains and gluten, together with reduced intake of refined carbohydrates, revolutionizes the sufferer’s health and is the only treatment necessary. Supplements of vitamins, minerals and amino acids, taken especially during the first twelve months of a gluten-free diet, will speed up the recovery process.
Unfortunately, the incidence of cancer in patients with adult coeliac disease that remains undetected, is high, up to about 13 per cent. Lymphoma and carcinoma of the small intestine can be fatal complications of this distressing illness. Other illnesses, as potentially serious, can develop as a result of allergy overload due to increasing intolerance by the small intestine to a wide range of foods and substances.