Celiac disease Gentle diagnosis for children with gluten intolerance
Complaints such as stomachache or diarrhea occur in children again and again. If such symptoms occur, especially after eating certain foods, it could be due to a gluten intolerance. To find out, so far a gastroscopy was necessary. But now there is a gentler diagnostic option.
Diagnosis without stressful intervention
Most children have problems like abdominal pain or diarrhea. Such symptoms may also be an indication of a lifelong autoimmune disease: celiac disease (gluten intolerance). To confirm such a suspicion in children and adolescents, a gastroscopy was indispensable for decades. Experts now report that in many cases the diagnosis can be made even without this stressful intervention.
About one percent of children are affected
It is estimated that about one percent of children and adolescents in Europe suffer from the gluten intolerance celiac disease.
Eating Affected foods that contain the Gluten Gluten, it is triggered by a reaction of the immune system. This leads to chronic inflammation of the small intestinal mucosa.
The resulting symptoms range from digestive problems with abdominal pain, diarrhea, flatulence or constipation to decreased growth or anemia.
The exact causes that can lead to this intolerance are still unknown.
Celiac patients must pay close attention to their diet and give up all foods with gluten for life.
The gluten is mainly in cereals such as wheat, rye or barley contained, but not only hides in bread, but is also found in processed foods.
Gluten intolerance often goes unrecognized
Since the celiac disease signs are very diverse, the gluten intolerance often goes unrecognized.
For decades, a gastroscopy in children and adolescents was essential to confirm the diagnosis of celiac disease.
But a large international study - coordinated by Dr. med. from Haunerschen Children's Hospital of the Ludwig Maximilian University Munich - has now been able to show that in more than 50 percent of cases the diagnosis can be made reliably without this procedure.
The scientists recently published the study results in the journal "Gastroenterology".
Stressful gastroscopy with anesthesia
Children need to stay in the clinic during the day for gastroscopy with tissue removal. This is always associated with fears and inconvenience.
But the new "results finally bring clarity," said Prof. Dr. med. med. Sibylle Koletzko, Head of Pediatric Gastroenterology in Dr. med. from Haunerschen Children's Hospital at LMU-Klinikum according to a communication.
"This saves many children from the burdening gastroscopy with narcosis," says Koletzko, who coordinated the new study with her colleagues.
"In addition, this leads to significant cost savings in the health system, because in addition to the gastroscopy and the expensive genetic analysis is not necessary."
Celiac complaints often change
According to Koletzko celiac disease is also referred to as a chameleon among the diseases. This is because the symptoms often change.
"Celiac disease is one of the top ten overlooked diseases. It is very common, "said the expert, according to a message from the news agency dpa.
The researchers had collected data, laboratory and tissue samples from more than 700 children and adolescents with celiac autoantibodies in a total of 33 clinics in 21 countries.
These are immune-cell-derived antibodies that target their own tissues and cause inflammation in the gut.
Safe diagnosis based on specific complaints and blood tests
The study has shown that in many cases a reliable diagnosis can be made with specific results, including specific complaints and blood tests.
However, if the blood tests are less clear, according to Koletzko, a gastroscopy is still necessary.
In the statement of the hospital she advises "affected families for the diagnosis (with and without gastroscopy) to visit a child gastroenterologist or a pediatrician with additional expertise for gluten intolerance".
Whether celiac disease without biopsy can be reliably diagnosed even in children without obvious symptoms or in adults, should be clarified in further studies.
Gluten-free diet for healthy is not recommended
Although a gluten-free diet is not recommended for healthy people, some people avoid the gluten protein because they think this diet is especially healthy.
"The disease celiac disease must not be confused with the fashion trend" gluten sensitivity "and a self-imposed gluten-free diet, which can not be considered beneficial without necessity," said Koletzko in the dpa message.
In some cases, a gluten-free diet is even unhealthier, as important nutrients were missing from whole-grain products. (Ad)