In just a few decades, the word celiac disease has become a very common word among parents.
It is likely that our children will not find it as familiar as we do, but the reality is that now it is easy that in our children's environment there is a friend or colleague who suffers from this "permanent digestive intolerance to certain cereals", as they define it in the Spanish Association of Pediatrics (AEPED).
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The reason that this disease is better known to us than to previous generations has to do with the fact that it is now more easily diagnosable. And this is so thanks to the development of highly sensitive and specific serological tests that are also less invasive. The data provided by the AEPED speak of a prevalence of 1% of the population. And a REPAC study (Spanish Registry of Celiac Patients under 15 years of age) carried out by the Spanish Society of Pediatric Gastroenterology, Hepatology and Nutrition in which 24 hospitals with a defined healthcare area participated, “refers to a crude incidence of CD diagnosis of almost 8 for every 1,000 live newborns and 54 for every 100,000 children under 15 years of age ”, says Cristóbal Coronel Rodríguez,Primary Care pediatrician in Seville and member of the Scientific Committee of the Federation of Celiac Associations of Spain (FACE).
Precisely this federation
is in charge of organizing National Celiac Day every May 27
, because, despite having such a high incidence in our country, they still see the need to “give visibility and support to people with celiac disease with the intention of to normalize the life of the group, "they say on their website. One proof of this is that many believe that it is an allergy, but it is something more complex, as Coronel Rodríguez tells us. "It is a systemic disorder of an autoimmune nature caused by the ingestion of gluten in genetically predisposed individuals and characterized by the presence of different types of digestive or extra-digestive symptoms, a lesion of the intestinal mucosa of variable degree and an increase in specific antibodies in blood ”.
The direct result of the diagnosis of this disease is that those who suffer from it cannot eat gluten-containing foods again for their entire lives. And we speak of many years if we take into account that it is usually diagnosed in childhood. "Although celiac disease affects all age groups, including the elderly, it is five times more common in children than in adults, and the female-male ratio is two to one," says the pediatrician. But there is no curative treatment.
This is one of the reasons why Dr. Coronel Rodríguez insists on the importance of making a good diagnosis: "We are conditioning life, the quality of life of the sick, and of those around him, forever." And that is saying a lot, because unless we have a very close case, we cannot get used to the idea of the amount of foods and products that contain gluten, because they are not only those “made with flour, such as bread, pastries and pastries and pasta, and beer. In small amounts they are also found in many other foods ”, they warn in the AEPED.
Cristóbal Coronel confirms it: “The Mediterranean diet supposes an average exposure of 10-15 grams of gluten per day, so it is not easy to exclude it. It is estimated that gluten is part of 80% of manufactured foods, either directly or as a thickener, flavor carrier and binders. Furthermore, gluten-free products tend to be scarcer and more expensive than gluten-free equivalents, representing an extra expense for the family unit ”. This page of the AEPED informs about the ingredients that usually contain gluten and that are prohibited for celiacs, unless the FACE indicates it as allowed in their
Chiquilista
, which is accessed through a mobile APP with a Code bar scanner.
But we also have to face what it means for the child not to be able to eat something as simple as the cereals of his brothers or his friends or the cookies from the supermarket. “For this reason, a multidisciplinary approach is recommended in which, in addition to the pediatric gastroenterologist, specialists in dietetics and psychology intervene. We can help children by signing up with their parents to Celiac Associations ”, advises Coronel Rodríguez. In these associations they are encouraged to participate in workshops and are taught to communicate to friends and family the situation, the risk and the possibilities of making mistakes that, according to the experts, are more common than desired.
They refer to details that are not always easy to internalize, such as avoiding sharing oils to fry foods with and without gluten; toast the bread in a toaster that is used for bread with gluten; or share kitchen utensils. “In those houses where there is a celiac, it is recommended to eliminate wheat flours and normal breadcrumbs. Instead you can use rice, chickpea or corn flours, gluten-free breadcrumbs, mashed potato flakes, etc. to coat, bread or thicken sauces ”, affirm the pediatricians of the AEPED.
The effort of families is necessary. Just as it is to be attentive to children presenting symptoms of celiac disease. Failure to do so supposes a delay in the diagnosis, which can lead to “a shorter final height, a lower peak of bone mass, that the child is treated for other diseases that he does not have; poor school and / or sports performance (associated with anemia, muscle weakness, fatigue, etc.); Unexplained psychiatric or behavioral disturbances (irritability, apathy, sadness, laxity, introversion) and long-term associated with the appearance of other immunological or autoimmune or allergic diseases (bronchial asthma, inflammatory bowel disease, rheumatoid arthritis, diabetes mellitus and the appearance of digestive tumors and carcinomas ”, comments the member of the scientific council of FACE.
The most common symptom for children under two years of age is called
celiac habit
and “is characterized by the appearance of weight-loss or weight loss, chronic diarrhea, vomiting, loss of appetite, pain and abdominal distension that persist over time or they are repeat offenders ”. Although we must be careful because it is a disease with many forms of presentation, which is why it is classified as a chameleon. Coronel Rodríguez also refers to possible recurrent canker sores, alteration of the intestinal habit, decay, alteration of dental enamel, intolerance to dairy products ... For this reason, if there is any suspicion, he recommends consulting with the Primary Care pediatrician to start the complementary tests relevant.
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