Gluten intolerance : children can escape the endoscopy

MonaMakela/epictura

Published the 23.10.2017 at 11h53

A A

Keywords :

glutendiagnosticenfant

What is there to be used in breads, pastries, pasta, semolina, cheese spread, deli meats, and certain creams jellyfied, that can’t be found in dairy products, ham, fish, or fruit ? Well, it is the gluten, a protein that would never have done to talk about it if some people were completely intolerant.

What’s the frequency ?

This intolerance affects about one in 100 in our country. Therefore, six hundred thousand people who must constantly ask themselves the question to know if the food they are proposed do not contain a fraction of this terrible protein. Recall that if one likens our body to a wall, so the proteins are the bricks.

How can it be translated ?

The first troubles generally occur in the weeks following the introduction of the meal to the infant. The curve of weight is stagnating, or even falling. The infant is fretful, as yet, he has a good appetite, or always hungry. His stools are large. And it is especially these chronic diarrhea that alert the doctor.

In children, symptoms of celiac disease can be very variable. There may be digestive disturbances such as diarrhea, chronic or intermittent nausea and vomiting, and/or a lack of appetite. Sometimes, the child also suffers from recurrent abdominal pain or bloating due to an accumulation of intestinal gas. We can also observe signs of non-digestive as a weight loss and/or growth retardation, chronic fatigue, anemia due to iron deficiency, a delay in the onset of puberty.

Sometimes, however, the diagnosis can be made much later, in the adult, to a chronic diarrhea, which is the most common symptom, but also a constipation. Some adults suffer from abdominal pain or bloating associated with flatulence, and weight loss. The signs of non-digestive are many. It can be a chronic fatigue, anemia, iron deficiency, vitamin B9 or folic acid, canker sores recur, or osteoporosis in a young woman.

How to diagnose it ?

A simple blood test the signs of allergy-specific gluten antibodies, confirmed by a fiberoptic endoscopy, will help to put a name on the symptoms, but unfortunately will make life gourmet of the patient rather painful until the end of his days.

The dosage of the antibody immunoglobulin A (IgA) tissue transglutaminase is the test of choice to screen for celiac disease, and the suspicion must be confirmed by an assay of anti-endomysial and a search for the typing of HLA DQ2/DQ8. A fiberoptic endoscopy bowel with biopsies continues to be indispensable in the adult.

The fiberoptic endoscopy is essential ?

A large european study of over 800 children is attached to confirm that one could get spend of endoscopy for the diagnosis of gluten intolerance. This study was conducted in 21 countries and she is interested in the threshold value of the rate of specific antibody in the blood that can confirm the diagnosis of celiac disease, with a probability equal to that of endoscopy.

In this beautiful study, it is confirmed that the presence of an antibody to tissue transglutaminase at a rate greater than 10 times normal, is associated with any of the clinical signs common, has a predictive value close to 100. The HLA typing does not add much. The conclusion is that the positivity of this test, confirmed by an assay of the positive antibody anti-endomysial, would avoid endoscopy in more than half of the children are suffering, and a source of economy.

What is the treatment ?

Once the disease is diagnosed, the treatment principle is based on a diet excluding gluten. It is simple in theory, but its implementation is not a trivial matter. For products purchased in the trade, the composition theoretically mandatory must report it. But it becomes pretty darn more complicated when it comes to food prepared by a restaurant or, more serious, because it is the most common situation, in the canteen. It becomes a mission almost impossible, and imposes a kind of bet on the margin of the community. One who suffers from gluten intolerance must therefore be alerted constantly and engage in real police investigations. Because the call to order was almost immediate.

The diet is the only treatment ?

Yes, it is the only known treatment today, pending the availability of an enzyme substitution, sufficiently greedy to destroy the gluten. This would allow the development of an effective drug, whereas today, the only contribution of the pharmacy is to offer a series of gluten-free foods, unfortunately, not very cheap.