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Management of celiac disease.
K K Kalra1, N Jain, S K Mittal
1Department of Pediatrics, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi.
Indian Journal of Pediatrics
|January 2, 2001
Summary
Celiac disease (CD) is a significant cause of chronic diarrhea in children, with diagnosis confirmed by biopsy and gluten-free diet response. Strict adherence is crucial for growth, but challenges like awareness and diet availability persist.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Nutrition Science
Background:
- Celiac disease (CD) was historically considered rare but is now recognized as a notable cause of chronic diarrhea in children.
- Diagnosis in 7.5% of 800 pediatric chronic diarrhea cases highlights its increasing prevalence.
Purpose of the Study:
- To investigate the diagnosis, management, and long-term outcomes of celiac disease in post-weaned children.
- To identify factors affecting adherence to a gluten-free diet and its impact on growth.
Main Methods:
- Diagnosis based on clinical history, small bowel mucosal histopathology, and response to gluten-free diets.
- Follow-up of 34 children for growth parameters (height, weight) over a mean period of 3.45 years.
Main Results:
- All diagnosed children showed catch-up growth after initiating a gluten-free diet, with rapid gains in the first year.
- Growth curve flattening occurred in 9 subjects due to non-compliance and dietary inadequacies.
- Challenges to gluten-free diet adherence in India include wheat's staple status, lack of awareness, and dietary contamination.
Conclusions:
- Celiac disease is a significant pediatric concern requiring strict gluten-free diet adherence for optimal growth.
- Addressing challenges in diet accessibility, awareness, and family cooperation is vital for effective CD management.
- National efforts and Celiac Societies are crucial for supporting patients with this chronic condition.