Does your child have frequent headaches, skin rashes, stomach aches, is not gaining weight and/or is frequently tired? He or she may have celiac disease, an immune disorder caused by an intolerance to gluten. To find answers, read this informative blog by Mason Gomberg, MD, a pediatrician in our Westchester Health Pediatrics group.
What foods to eliminate or avoid to help your child’s condition improve
If your child is diagnosed with celiac disease, your pediatrician will advise you regarding which foods he/she can eat and which to avoid. Because these dietary changes can also affect the rest of your family and your daily routine, we suggest that you meet with a nutritionist for further guidance.
In general, your child should stay away from foods that contain the following gluten-related ingredients. NOTE: Because there is currently no law requiring food manufacturers to list gluten on food labels, avoiding gluten can be really hard to do in some cases.
- wheat, barley rye, and related grains should be eliminated
- bouillon and broths
- breading (such as the coating on breaded chicken cutlets, etc.)
- brown rice syrup (often made from barley)
- cake flour (made from wheat)
- caramel color (occasionally made from barley)
- communion wafers
- creamed or breaded vegetables
- dextrin (a rare ingredient that may be made from wheat—maltodextrin is OK)
- dry roasted nuts (processing agents may contain wheat flour or flavorings)
- fried chicken
- french fries (if coated in flour)
- gravies and sauces (including some tomato and meat sauces)
- imitation bacon, crab or other seafood
- luncheon and processed meats
- malt or malt flavoring (usually made from barley)
- modified food starch (most food manufacturers now list the source of this ingredient, e.g., modified cornstarch, which is OK, or modified wheat starch, which is not)
- nondairy creamer
- salad dressings
- seasonings (pure spices are OK but check seasoning mixes for gluten-containing additives)
- some herbal teas and flavored coffees
- soup mixes and canned soups
- soy sauce and soy sauce solids (they may be fermented with wheat; don’t use them unless you verify with a dietitian that they’re OK)
- spreads, soft cheeses, and dips
- udon noodles
- wheat-free products (many wheat-free cookies and breads instead contain barley or rye flour which contains gluten and other gluten-containing ingredients)
- yogurts with wheat starch
- certain 0ver-the-counter medications
- vitamin, nutritional and herbal supplements
- lipstick products
3 important things to remember
- To avoid gluten—and prevent triggering your child’s celiac symptoms—it’s important to carefully read the labels of all foods before you buy them or let your child consume them. Help your child learn to do this, too. When in doubt, the safest thing to do is to assume the product contains gluten and avoid it.
- In the U.S., all foods must be clearly labeled if they contain any of the top 8 food allergens, including wheat. However, wheat-free doesn’t mean gluten-free. Some wheat-free products may still have gluten-containing grains like barley and rye in them. Lawmakers are working to make labels easier to understand by requiring companies to identify these “hidden ingredients.”
- It’s generally safe for kids with celiac disease to eat oats that come from an uncontaminated source—oats that have been processed in a mill that doesn’t process grains that contain gluten with the same equipment. The label on the package should clearly state if this is the case.
What causes celiac disease?
- We don’t know for sure what triggers the immune system to react to gluten and then develop into celiac disease. In some people, the disease has been linked to other health conditions, including Turner syndrome, autoimmune thyroid disorder, Addison’s disease, rheumatoid arthritis, microscopic colitis, Down syndrome, diabetes, Williams syndrome, thyroid disorders and selective immunoglobulin IgA deficiency. In addition, a rash called dermatitis herpetiformis is associated with intestinal gluten.
- Unfortunately, there is no cure (other than avoiding gluten), although researchers are working on developing enzyme pills to help with the digestion of the toxic part of gluten that causes intestinal damage.
- Celiac disease tends to run in families, so if there is a family history of celiac disease, children may have a higher risk of developing it. If one child is diagnosed with celiac disease, his or her siblings, parents and grandparents should be tested too, as they may have the disease but no symptoms.
- Celiac disease that goes undiagnosed or untreated can lead to weight loss, loss of calcium and bone density, reproductive issues, lactose intolerance, dental enamel disease, seizures and increased risk for small bowel cancer and lymphoma.
Celiac disease can lead to a wide variety of symptoms in different people
- In infants, this might mean that they aren’t gaining weight and height as expected (“failure to thrive”), often accompanied by diarrhea and/or stomach pain.
- Older kids can have diarrhea, abdominal pain, bloating, weight loss, fatigue, acne or skin rashes (especially around the elbows, buttocks, and knees). Over time, kids with celiac disease might develop anemia and mouth sores, and become withdrawn or irritable. On the other hand, some people with celiac disease have no symptoms at all.
- It’s also important to know that the symptoms of celiac disease can happen at any time in your child’s development. Some kids have symptoms the first time they are exposed to gluten, while others develop symptoms after safely eating gluten for years.
Fortunately, celiac disease symptoms improve quickly when gluten is eliminated from the diet (often in a few weeks to months).
Learn more about celiac disease
There are several websites and support groups which are available to help you navigate through the lifestyle changes required for children with celiac disease. Here are some suggestions:
- Celiac Disease Foundation
- National Celiac Association
- Beyond Celiac
- Gluten Free Help Info
- Celiac Support Association
If you think your child may have celiac disease, please come see us
If your child is showing signs of celiac disease, please make an appointment with Westchester Health to come in and see one of our pediatricians. We will meet with you and your child, review the symptoms, possibly order some tests, and together with you, decide on the best course of action which may include avoidance of gluten. Whatever the diagnosis, our #1 goal is for your child to get answers and feel better as soon as possible. Whenever, wherever you need us, we’re here for you.
To read Dr. Gomberg’s blog in full, click here.