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Celiac diseaseCCeliac diseaseCeliac diseaseEnglishGastrointestinalBaby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)Small IntestineSmall intestineConditions and diseasesCaregivers Adult (19+)NA2017-02-06T05:00:00ZPeggy Marcon, MD, FRCPC;Inez Martincevic, MSc, RD;Catharine Walsh, MD, MEd, PhD, FAAP, FRCPC9.0000000000000055.00000000000001469.00000000000Health (A-Z) - ConditionsHealth A-Z<p>An overview of the causes, signs, treatment, and gluten-free diet tips for children diagnosed with this medical condition. </p><h2>What is celiac disease?</h2><p>In people with celiac disease, any contact with gluten (a family of food proteins) triggers a reaction from the body’s defense (immune) system. This immune response to gluten—no matter where in the body the contact happened—mainly results in damage to the gut (small intestine) lining. This is why celiac disease is called an autoimmune disease.</p><p>A healthy small intestine is lined with tiny finger-like projections (called villi) that stick up from the surface. Villi increase the area available to absorb nutrients from food. When children with celiac disease are exposed to gluten, the resulting immune reaction damages villi, which become flat. As a result:</p><ul><li>It becomes difficult to absorb nutrients. This is called malabsorption.</li><li>Lack of nutrients due to malabsorption may affect growth and development.</li><li>It also may cause digestive system (gastrointestinal) symptoms, such as <a href="/Article?contentid=7&language=English"> diarrhea</a> and stomach pain.</li></ul> <figure class="asset-c-100"><span class="asset-image-title">Celiac disease: Villi damage</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_celiac_disease_EN.jpg" alt="" /><figcaption class="asset-image-caption">With celiac disease the finger-like projections (villi) found in the small intestine become damaged and flattened. This makes absorbing nutrients difficult.</figcaption> </figure> <h3>What is gluten?</h3><p>Gluten is the name of a family of proteins found in grains. Gliadin and glutenin are the two main gluten proteins.</p><p>Gluten is found in:</p><ul><li>all forms of wheat (including durum, semolina, spelt, kamut, einkorn and farro)<br></li><li>rye</li><li>barley</li><li>triticale (rye and barley mix).</li></ul><h2>Key points</h2> <ul> <li>Celiac disease is an autoimmune condition in which any contact with gluten (a family of food proteins) triggers a reaction from the body’s defense (immune) system.</li> <li>Gluten is found in rye, barley, triticale and all forms of wheat.</li> <li>In celiac disease, the lining of the small intestine is damaged by the immune system reaction. This means that it will be harder for your child’s body to get nutrients from foods.</li> <li>Common symptoms of celiac disease include diarrhea, constipation, tiredness, headaches and poor growth. Some people experience no symptoms at all.</li> <li>The only treatment for celiac disease is following a strict gluten-free diet for life. Never get your child to start a gluten-free diet before your doctor confirms the diagnosis.</li> </ul><h2>Signs and symptoms of celiac disease</h2><p>Some people with celiac disease may have no symptoms at all.</p><p>However, many people with celiac disease experience some symptoms. When a person with celiac disease is exposed to gluten, they may have trouble with their digestive system, malabsorption-related issues and other symptoms. Below are some common symptoms of celiac disease. Some people may only have one of these symptoms, while others may experience multiple symptoms.<br></p> <a href="https://assets.aboutkidshealth.ca/akhassets/CeliacSymptoms_poster.pdf"> <figure class="asset-small"> <img alt="Download celiac symptoms poster PDF" src="https://assets.aboutkidshealth.ca/akhassets/celiac_symptoms_PDFdownload.jpg" /> </figure> </a> <h3>Digestive system symptoms</h3><p>When a person with celiac disease is exposed to gluten, they may experience one or more of the following digestive system symptoms:</p><ul><li> <a href="/Article?contentid=822&language=English">excessive gas</a></li><li>diarrhea</li><li> <a href="/Article?contentid=6&language=English">constipation</a></li><li> <a href="/Article?contentid=823&language=English">irritable bowel</a> symptoms</li><li>stomach cramps and/or tummy pain</li><li>nausea</li><li> <a href="/Article?contentid=746&language=English">vomiting</a></li><li>bloating of the abdomen (tummy)</li><li>abdominal distension (expansion)</li><li>decrease in appetite</li><li>indigestion</li></ul><h3>Malabsorption-related symptoms</h3><p>They may also experience one or more symptoms that are not related to the digestive system but are due to nutrient malabsorption. These may include:</p><ul><li> <a href="/Article?contentid=841&language=English">anemia</a> (low blood haemoglobin from iron malabsorption)</li><li>fatigue</li><li>poor growth (being shorter than expected)</li><li>weight loss or poor weight gain</li><li>delayed puberty</li><li> <a href="/Article?contentid=1453&language=English">vitamin or mineral </a>deficiencies (e.g. <a href="/Article?contentid=1448&language=English">calcium</a>, <a href="/Article?contentid=1446&language=English">B12</a>, vitamins A, <a href="/Article?contentid=1447&language=English">D</a>, E and K)</li></ul><h3>Brain</h3><p>A person with celiac disease may experience one or more symptoms affecting their mental health including:</p><ul><li> <a href="/Article?contentid=29&language=English">headaches</a> or migraines</li><li>difficulty concentrating</li><li> <a href="/Article?contentid=19&language=English">depression</a></li><li> <a href="/Article?contentid=18&language=English">anxiety</a></li><li>mood swings and irritability</li></ul><h3>Skin</h3><p>People with celiac disease may also experience skin conditions including:</p><ul><li>skin rash (dermatitis herpetiformis)</li><li>brittle nails</li></ul><h3>Mouth</h3><p>Symptoms of celiac disease that affect the mouth include:</p><ul><li>mouth sores</li><li>tooth enamel defects</li></ul><h3>Reproductive</h3><p>Both males and females with celiac disease may experience issues related to reproduction including:</p><ul><li>infertility (difficulty conceiving children, in both men and women)</li><li>miscarriage</li><li>menstrual irregularities</li></ul><h3>Body</h3><p>Other celiac disease symptoms that could affect parts of the body include:</p><ul><li>osteopenia (mild) or <a href="/Article?contentid=948&language=English">osteoporosis </a> (more serious bone density problem)</li><li>joint pain</li><li>fatigue</li><li>liver and biliary tract disorders</li></ul><h2>Causes of celiac disease</h2> <p>Celiac disease affects about 350,000 Canadians (roughly 1 in 100). It occurs in people all over the world and at any age. People develop celiac disease because of a combination of a genetic susceptibility and environmental factors. If the two conditions are met, some people will develop the condition.</p> <p>People with a relative with celiac disease or who have certain genetic conditions (such as <a href="/Article?contentid=9&language=English">Down syndrome</a> or <a href="/Article?contentid=869&language=English">Turner syndrome</a>) are at higher risk of developing celiac disease.</p> <p>People who already have one autoimmune condition, such as <a href="/Article?contentid=1719&language=English">type 1 diabetes</a>, are at higher risk for developing other autoimmune conditions, such as celiac disease.</p><h2>How celiac disease is diagnosed</h2><h3>Blood tests</h3><p>Doctors can order blood tests to screen for celiac disease. These blood tests look for immune proteins (called auto-antibodies) that the body has made in response to gluten in people with celiac disease.</p><p>The possible blood tests include:</p><ul><li>Anti-tissue transglutaminase (TTG) antibodies</li><li>Anti-deamidated gliaden peptide (DGP) antibodies</li><li>Anti-endomysial antibodies (EMA)</li></ul><p>Your doctor does not need to order all of these blood tests to screen for celiac disease. </p><p>Depending on the results, your doctor or health-care provider will talk to you about further testing to confirm celiac disease. </p><h3>Upper endoscopy</h3><p>An <a href="/Article?contentid=2472&language=English">upper endoscopy</a> may help confirm the diagnosis. An upper endoscopy is a procedure that allows doctors to see the upper part of your child’s digestive system (from the mouth to the top part of the small intestine). Never start your child on a gluten-free diet before you know for sure whether an upper endoscopy is needed to confirm the diagnosis of celiac disease.</p> <figure class="asset-c-80"><span class="asset-image-title">Upper endoscopy</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_endoscope_EN.jpg" alt="" /><figcaption class="asset-image-caption">During an upper endoscopy, a thin flexible tube with a camera on the end is inserted into the mouth and down the esophagus to look at the esophagus, stomach, and duodenum (top part of the small intestine).</figcaption> </figure> <h3>Biopsy of the small intestine</h3><p>During an upper endoscopy, small pieces of tissue (biopsies) of the small intestine are taken; they will be examined under a microscope. If your child has celiac disease, the biopsy will show changes to villi in the sample from the small intestine.</p><p>Never start your child on a gluten-free diet without first getting a confirmed diagnosis of celiac disease. If a biopsy is done after your child starts a gluten-free diet, your child’s villi may look normal because they will have had a chance to heal since the immune response will have stopped. The biopsy may give a false negative result, which means that the result is negative even though your child has celiac disease.</p><p>Talk to your child’s doctor for more information about screening for celiac disease.</p><h2>Treatment of celiac disease</h2><p>Celiac disease is a life-long condition. There is no cure or medication for celiac disease. The only treatment is a strict gluten-free diet for life. The diet will help with the symptoms and will keep your child healthy.</p><p>Even if your child has no symptoms, once diagnosed your child must follow a strict gluten-free diet for life for treatment of the disease. </p><p>Your child must also limit skin contact with <a href="/Article?contentid=956&language=English">gluten-containing products</a>. Gluten-containing products can include food or non-food items (for example, hand cream). Contact with gluten can trigger skin reactions in some people with celiac disease. It is also possible for people with celiac disease to transfer gluten from their skin to their mouth and gut when they are in contact with gluten, which is not safe.</p><h3>Starting treatment: The gluten-free diet</h3><p>Once gluten is removed from your child’s diet, the small intestine will start to heal. Your child should start to feel better and symptoms should improve after about six months of being strictly gluten-free. </p><h3>Maintaining treatment: Sticking to a gluten-free diet</h3><p>Do not stop the gluten-free diet if your child’s symptoms improve. Your child is feeling better because the gluten-free diet is working. If you stop the gluten-free diet, the symptoms are going to come back and the villi will flatten. Even if your child has no symptoms, stopping the gluten-free diet will damage the villi and any previous symptom is going to return.</p><p>If your child’s symptoms of celiac disease do not improve after six months, contact your doctor.</p><p>These <a href="/Article?contentid=957&language=English">tips and resources</a> can help you and your child stick to a strict gluten-free diet.</p><h3>What happens without a gluten-free diet?</h3><p>Gluten is toxic to people with celiac disease because it triggers an immune reaction even if your child shows no symptoms.</p><p>If your child continues to be exposed to gluten, celiac disease may lead to future health problems including:</p><ul><li>low bone density (osteopenia or osteoporosis)</li><li>some small bowel cancers</li><li>other autoimmune diseases (for example thyroid problems)</li><li> <a href="/Article?contentid=1453&language=English">vitamins and mineral</a> deficiencies because of malabsorption</li><li> <a href="/Article?contentid=2499&language=English">premature delivery</a> if pregnant</li></ul><p>If your child follows a strict gluten-free diet, their chances of getting these conditions become the same as the general healthy population.</p><h2>When to see a doctor</h2> <p>See your child’s doctor if:</p> <ul> <li>your child’s symptoms remain after more than six months of following a strict gluten-free diet</li> <li>your child’s symptoms worsen</li> </ul> <p>Your child’s doctor may refer you to a dietitian. A dietitian can give you more advice about celiac disease, how to plan a gluten-free diet, and how to get a balance of nutrients while following a gluten-free diet.</p>
Maladie cœliaqueMMaladie cœliaqueCeliac diseaseFrenchGastrointestinalBaby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)Small IntestineSmall intestineConditions and diseasesCaregivers Adult (19+)NA2017-02-06T05:00:00ZPeggy Marcon, MD, FRCPC;Inez Martincevic, MSc, RD;Catharine Walsh, MD, MEd, PhD, FAAP, FRCPC9.0000000000000055.00000000000001469.00000000000Health (A-Z) - ConditionsHealth A-Z<p> Voici un aperçu facile à comprendre des causes, des signes et des traitements de la maladie, et des conseils nutritionnels sur des aliments sans gluten pour les enfants qui reçoivent le diagnostic. </p><h2>Qu’est-ce que la maladie cœliaque?</h2><p>Chez les personnes atteintes de la maladie cœliaque, tout contact avec le gluten, un groupe des protéines alimentaires, déclenche une réaction du système immunitaire, le système de défense de l’organisme. Cette réponse immunitaire au gluten, peu importe où le contact se produit dans le corps, se traduit principalement par des dommages aux parois internes de l’intestin grêle. C’est la raison pour laquelle on appelle la maladie cœliaque une maladie auto-immune.</p><p>Un intestin grêle sain est tapissé de minuscules saillies en forme de doigts appelées villosités. Ces villosités augmentent la surface d’absorption des nutriments. Lorsqu’un enfant est atteint de la maladie cœliaque et qu’il est exposé au gluten, la réaction immunitaire endommage les villosités, qui s’aplatissent. Par conséquent :</p><ul><li>L’absorption des nutriments devient plus difficile. Ce phénomène s’appelle trouble de malabsorption.</li><li>Le manque de nutriments causé par la malabsorption peut nuire à la croissance et au développement de l’organisme.</li><li>La malabsorption peut aussi provoquer des symptômes touchant le système gastro-intestinal tels que la <a href="/Article?contentid=7&language=French">diarrhée</a> et les douleurs d’estomac.</li></ul> <figure class="asset-c-100"><span class="asset-image-title">La maladie cœliaque : dommages causés aux villosités intestinales</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_celiac_disease_FR.jpg" alt="" /><figcaption class="asset-image-caption">La maladie cœliaque endommage et aplatit les saillies (villosités) que l’on trouve dans l’intestin grêle. L’absorption des nutriments devient alors difficile.</figcaption></figure> <h3>Qu’est-ce que le gluten?</h3><p>Le gluten est le nom d’un groupe de protéines que l’on trouve dans les céréales. Les gliadines et les gluténines sont les deux principales composantes protéiques du gluten.</p><p>On trouve le gluten dans les aliments suivants :</p><ul><li>toutes les formes de blé (notamment le blé dur, la semoule de blé, l’épeautre, le kamut, le petit épeautre et le blé amidonnier);</li><li>le seigle;</li><li>l’orge;</li><li>le triticale (une hybridation entre le blé et le seigle).</li></ul><h2>À retenir</h2> <ul><li>La maladie cœliaque est une maladie auto-immune dans laquelle tout contact avec le gluten, un groupe de protéines alimentaires, déclenche une réaction du système immunitaire, le système de défense de l’organisme.</li> <li>On trouve du gluten dans le seigle, l’orge, le triticale et toutes les formes de blé.</li> <li>Avec la maladie cœliaque, les parois internes de l’intestin grêle sont endommagées par la réaction du système immunitaire. L’absorption des nutriments contenus dans les aliments est ainsi affectée.</li> <li>Les symptômes courants de la maladie cœliaque sont la diarrhée, la constipation, la fatigue, les maux de tête et une faible croissance. Certaines personnes ne présentent aucun symptôme.</li> <li>Le seul traitement de la maladie cœliaque est un régime alimentaire strictement sans gluten à vie. Ne commencez jamais un régime sans gluten chez votre enfant avant d’obtenir un diagnostic confirmé de votre médecin.</li></ul><h2>Signes et symptômes de la maladie cœliaque</h2> <p>Certaines personnes atteintes de la maladie cœliaque peuvent ne présenter aucun symptôme. De nombreuses autres, cependant, atteintes de la maladie cœliaque présentent certains symptômes. Lorsqu’une personne atteinte de cette maladie est exposée au gluten, elle peut présenter des problèmes liés au système digestif et à la malabsorption, ou d’autres symptômes.</p> <h3>Symptômes touchant le système digestif</h3> <p>Lorsqu’une personne atteinte de la maladie cœliaque est exposée au gluten, elle peut présenter l’un ou plusieurs des symptômes suivants touchant le système digestif :</p> <ul><li><a href="/Article?contentid=822&language=French">excès de gaz</a>;</li> <li>diarrhée;</li> <li><a href="/Article?contentid=6&language=French">constipation</a>;</li> <li>crampes d’estomac ou mal de ventre;</li> <li>nausées;</li> <li><a href="/Article?contentid=746&language=French">vomissements</a>;</li> <li>ballonnements.</li></ul> <h3>Symptômes liés à la malabsorption</h3> <p>La personne atteinte peut aussi présenter un ou plusieurs symptômes qui ne sont pas liés au système digestif, mais qui sont causés par une malabsorption des nutriments. Ces symptômes sont principalement :</p> <ul><li>l’<a href="/Article?contentid=841&language=French">anémie</a> (faible taux d’hémoglobine due à une malabsorption du fer); </li> <li>la fatigue;</li> <li>une faible croissance (plus lente que la normale);</li> <li>un retard de la puberté;</li> <li>une usure de l’émail dentaire;</li> <li>une ostéopénie (problème de densité osseuse léger) ou <a href="/Article?contentid=948&language=French">ostéoporose</a> (problème de densité osseuse plus grave).</li></ul> <h3>Autres symptômes</h3> <p>D’autres symptômes peuvent comprendre :</p> <ul><li>une éruption cutanée (dermatite herpétiforme);</li> <li>des douleurs articulaires;</li> <li>la <a href="/Article?contentid=19&language=French">dépression</a>;</li> <li>l’<a href="/Article?contentid=18&language=French">anxiété</a>;</li> <li>des maux de tête;</li> <li>des troubles du foie;</li> <li>l’infertilité (difficulté à concevoir chez les hommes et les femmes).</li></ul><h2>Causes de la maladie cœliaque</h2> <p>La maladie cœliaque touche environ un pour cent des Canadiens (environ 350 000 habitants). Elle est diagnostiquée partout à travers le monde et elle touche des gens de tous âges. Les personnes développent la maladie cœliaque en raison d’une prédisposition génétique ainsi que de facteurs environnementaux. Si ces deux conditions sont réunies, certaines personnes vont développer la maladie.</p> <p>Les personnes qui ont un parent atteint de la maladie cœliaque ou qui sont atteintes de certains troubles comme le <a href="/Article?contentid=9&language=French">syndrome de Down</a> ou le <a href="/Article?contentid=869&language=French">syndrome de Turner</a> sont plus à risque de développer la maladie cœliaque.</p> <p>Celles qui ont déjà une maladie auto-immune comme le diabète de type 1 sont aussi plus à risque de développer d’autres maladies auto-immunes comme la maladie cœliaque.</p><h2>Comment pose-t-on un diagnostic de maladie cœliaque</h2><h3>Analyses sanguines</h3><p>Le médecin peut demander des analyses sanguines en vue de dépister la maladie. Ces analyses détectent des protéines immunitaires appelées auto-anticorps que l’organisme produit en réaction au gluten chez les personnes atteintes de la maladie cœliaque.</p><p>Les analyses sanguines peuvent détecter, notamment :</p><ul><li>les auto-anticorps antitransglutaminase tissulaire (anti-tTG);</li><li>les anticorps anti-gliadines déamidées (IgA);</li><li>les anticorps anti-endomysium (AcE).</li></ul><p>Votre médecin n’a pas nécessairement besoin de prescrire toutes ces analyses sanguines pour dépister la maladie cœliaque.</p><p>Selon les résultats, votre médecin ou votre fournisseur de soins de santé pourra recommander d’autres analyses pour confirmer qu’il s’agit de la maladie cœliaque.</p><h3>Endoscopie digestive haute</h3><p>Une <a href="/Article?contentid=2472&language=French">endoscopie digestive haute</a> peut faciliter la confirmation du diagnostic. Cet examen permet au médecin de visualiser la partie supérieure du système digestif de votre enfant (de la bouche jusqu’à la partie supérieure de l’intestin grêle). Ne commencez jamais un régime alimentaire sans gluten chez votre enfant sans avoir la certitude qu’une endoscopie digestive haute est nécessaire pour confirmer un diagnostic de maladie cœliaque.</p> <figure class="asset-c-80"> <span class="asset-image-title">Endoscopie digestive haute</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_endoscope_FR.jpg" alt="" /><figcaption class="asset-image-caption">Pendant l’endoscopie digestive haute, un mince tube flexible muni d’une caméra à l'extrémité est inséré dans la bouche jusqu’en bas de l’œsophage afin d’examiner l’œsophage, l’estomac et le duodénum (partie supérieure de l'intestin grêle).</figcaption> </figure> <h3>Biopsie de l’intestin grêle</h3><p>Au cours d’une endoscopie digestive haute, on prélève quelques fragments de tissus de l’intestin grêle (c’est ce qu’on appelle une biopsie); ces fragments sont ensuite examinés au microscope. Si votre enfant est atteint de la maladie cœliaque, une biopsie permettra de connaître les dommages causés aux villosités grâce à l’échantillon prélevé dans l’intestin grêle.</p><p>Ne commencez jamais un régime alimentaire sans gluten pour votre enfant sans d’abord obtenir un diagnostic confirmé de la maladie cœliaque. Si une biopsie est effectuée après que votre enfant a commencé un régime sans gluten, ses villosités pourront paraître normales, car elles auront eu le temps de guérir après l’interruption de la réponse immunitaire. Une biopsie pourrait alors donner un résultat faussement négatif même si votre enfant est atteint de la maladie cœliaque.</p><p>Consultez votre médecin pour obtenir plus de renseignements sur le dépistage de la maladie cœliaque.</p><h3>Traitement de la maladie cœliaque</h3> <p>La maladie cœliaque est un trouble chronique (à vie). Il n’existe aucun remède ni médicament pour cette maladie. Le seul traitement est un régime alimentaire strictement sans gluten, à vie. Ce régime atténue les symptômes et aide à maintenir votre enfant en bonne santé.</p> <p>Même s’il ne présente aucun symptôme, une fois que le diagnostic est posé, votre enfant devra suivre un régime strictement sans gluten à vie pour traiter sa maladie.</p> <p>Il devra aussi limiter tout contact cutané (de la peau) avec des produits contenant du gluten. Ces produits peuvent être aussi bien alimentaires que non alimentaires (comme la crème pour les mains). Le contact du gluten avec la peau peut déclencher des réactions cutanées chez certaines personnes atteintes de la maladie cœliaque. Il peut aussi arriver que les personnes atteintes transmettent le gluten de leur peau à leur bouche, puis à leur intestin lorsqu’ils sont en contact avec le gluten, ce qui présente des risques.</p> <h3>Traitement de base : un régime alimentaire sans gluten</h3> <p>Une fois que le gluten est supprimé de l’alimentation de votre enfant, l’intestin grêle commence alors à guérir. Votre enfant devrait commencer à se sentir mieux et ses symptômes devraient s’atténuer après environ six mois de régime alimentaire strictement sans gluten.</p> <h3>Maintien du traitement : poursuite du régime sans gluten</h3> <p>N’interrompez pas le régime sans gluten dès que les symptômes de votre enfant commencent à diminuer. Votre enfant se sent mieux parce que le régime sans gluten est déjà en action. Si vous interrompez le régime sans gluten parce que votre enfant ne présente plus de symptomes, ces derniers réapparaîtront et les villosités s’aplatiront et seront endommagées.</p> <p>Si les symptômes de la maladie cœliaque chez votre enfant ne diminuent pas au bout de six mois, consultez votre médecin.</p> <p>Ces <a href="/Article?contentid=957&language=French">conseils et ressources​</a> peuvent vous aider, vous et votre enfant, à maintenir un régime strictement sans gluten.</p> <h3>Que se passe-t-il si mon enfant continue de consommer du gluten?</h3> <p>Le gluten est toxique pour les personnes atteintes de la maladie cœliaque parce qu’il déclenche une réaction immunitaire, et ce, même si votre enfant ne présente aucun symptôme.</p> <p>Si celui-ci continue d’être exposé au gluten, la maladie cœliaque pourra entraîner des problèmes de santé, notamment :</p> <ul><li>une faible densité osseuse (ostéopénie ou ostéoporose);</li> <li>le cancer de l’intestin grêle;</li> <li>d’autres maladies auto-immunes comme les problèmes de thyroïde;</li> <li>une carence en vitamines et minéraux en raison d’une malabsorption;<br></li> <li>un <a href="/article?contentid=465&language=French">risque d’accouchement prématuré​</a> lors d’une grossesse.</li></ul> <p>Si votre enfant suit un régime strictement sans gluten, ses chances de présenter les troubles ci-dessus deviennent alors similaires à celles de la population générale en bonne santé.</p><h2>Quand consulter un médecin</h2> <p>Consultez votre médecin si :</p> <ul><li>les symptômes de votre enfant perdurent après plus de six mois de régime strictement sans gluten;</li> <li>les symptômes de votre enfant s’aggravent.</li></ul> <p>Votre médecin pourra vous aiguiller vers un diététicien. Un diététicien peut vous fournir davantage de conseils sur la maladie cœliaque et sur la façon de planifier et de suivre un régime sans gluten tout en obtenant les nutriments nécessaires.</p>

 

 

Celiac disease816.000000000000Celiac diseaseCeliac diseaseCEnglishGastrointestinalBaby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)Small IntestineSmall intestineConditions and diseasesCaregivers Adult (19+)NA2017-02-06T05:00:00ZPeggy Marcon, MD, FRCPC;Inez Martincevic, MSc, RD;Catharine Walsh, MD, MEd, PhD, FAAP, FRCPC9.0000000000000055.00000000000001469.00000000000Health (A-Z) - ConditionsHealth A-Z<p>An overview of the causes, signs, treatment, and gluten-free diet tips for children diagnosed with this medical condition. </p><h2>What is celiac disease?</h2><p>In people with celiac disease, any contact with gluten (a family of food proteins) triggers a reaction from the body’s defense (immune) system. This immune response to gluten—no matter where in the body the contact happened—mainly results in damage to the gut (small intestine) lining. This is why celiac disease is called an autoimmune disease.</p><p>A healthy small intestine is lined with tiny finger-like projections (called villi) that stick up from the surface. Villi increase the area available to absorb nutrients from food. When children with celiac disease are exposed to gluten, the resulting immune reaction damages villi, which become flat. As a result:</p><ul><li>It becomes difficult to absorb nutrients. This is called malabsorption.</li><li>Lack of nutrients due to malabsorption may affect growth and development.</li><li>It also may cause digestive system (gastrointestinal) symptoms, such as <a href="/Article?contentid=7&language=English"> diarrhea</a> and stomach pain.</li></ul> <figure class="asset-c-100"><span class="asset-image-title">Celiac disease: Villi damage</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_celiac_disease_EN.jpg" alt="" /><figcaption class="asset-image-caption">With celiac disease the finger-like projections (villi) found in the small intestine become damaged and flattened. This makes absorbing nutrients difficult.</figcaption> </figure> <h3>What is gluten?</h3><p>Gluten is the name of a family of proteins found in grains. Gliadin and glutenin are the two main gluten proteins.</p><p>Gluten is found in:</p><ul><li>all forms of wheat (including durum, semolina, spelt, kamut, einkorn and farro)<br></li><li>rye</li><li>barley</li><li>triticale (rye and barley mix).</li></ul><h2>Key points</h2> <ul> <li>Celiac disease is an autoimmune condition in which any contact with gluten (a family of food proteins) triggers a reaction from the body’s defense (immune) system.</li> <li>Gluten is found in rye, barley, triticale and all forms of wheat.</li> <li>In celiac disease, the lining of the small intestine is damaged by the immune system reaction. This means that it will be harder for your child’s body to get nutrients from foods.</li> <li>Common symptoms of celiac disease include diarrhea, constipation, tiredness, headaches and poor growth. Some people experience no symptoms at all.</li> <li>The only treatment for celiac disease is following a strict gluten-free diet for life. Never get your child to start a gluten-free diet before your doctor confirms the diagnosis.</li> </ul><h2>Signs and symptoms of celiac disease</h2><p>Some people with celiac disease may have no symptoms at all.</p><p>However, many people with celiac disease experience some symptoms. When a person with celiac disease is exposed to gluten, they may have trouble with their digestive system, malabsorption-related issues and other symptoms. Below are some common symptoms of celiac disease. Some people may only have one of these symptoms, while others may experience multiple symptoms.<br></p> <a href="https://assets.aboutkidshealth.ca/akhassets/CeliacSymptoms_poster.pdf"> <figure class="asset-small"> <img alt="Download celiac symptoms poster PDF" src="https://assets.aboutkidshealth.ca/akhassets/celiac_symptoms_PDFdownload.jpg" /> </figure> </a> <h3>Digestive system symptoms</h3><p>When a person with celiac disease is exposed to gluten, they may experience one or more of the following digestive system symptoms:</p><ul><li> <a href="/Article?contentid=822&language=English">excessive gas</a></li><li>diarrhea</li><li> <a href="/Article?contentid=6&language=English">constipation</a></li><li> <a href="/Article?contentid=823&language=English">irritable bowel</a> symptoms</li><li>stomach cramps and/or tummy pain</li><li>nausea</li><li> <a href="/Article?contentid=746&language=English">vomiting</a></li><li>bloating of the abdomen (tummy)</li><li>abdominal distension (expansion)</li><li>decrease in appetite</li><li>indigestion</li></ul><h3>Malabsorption-related symptoms</h3><p>They may also experience one or more symptoms that are not related to the digestive system but are due to nutrient malabsorption. These may include:</p><ul><li> <a href="/Article?contentid=841&language=English">anemia</a> (low blood haemoglobin from iron malabsorption)</li><li>fatigue</li><li>poor growth (being shorter than expected)</li><li>weight loss or poor weight gain</li><li>delayed puberty</li><li> <a href="/Article?contentid=1453&language=English">vitamin or mineral </a>deficiencies (e.g. <a href="/Article?contentid=1448&language=English">calcium</a>, <a href="/Article?contentid=1446&language=English">B12</a>, vitamins A, <a href="/Article?contentid=1447&language=English">D</a>, E and K)</li></ul><h3>Brain</h3><p>A person with celiac disease may experience one or more symptoms affecting their mental health including:</p><ul><li> <a href="/Article?contentid=29&language=English">headaches</a> or migraines</li><li>difficulty concentrating</li><li> <a href="/Article?contentid=19&language=English">depression</a></li><li> <a href="/Article?contentid=18&language=English">anxiety</a></li><li>mood swings and irritability</li></ul><h3>Skin</h3><p>People with celiac disease may also experience skin conditions including:</p><ul><li>skin rash (dermatitis herpetiformis)</li><li>brittle nails</li></ul><h3>Mouth</h3><p>Symptoms of celiac disease that affect the mouth include:</p><ul><li>mouth sores</li><li>tooth enamel defects</li></ul><h3>Reproductive</h3><p>Both males and females with celiac disease may experience issues related to reproduction including:</p><ul><li>infertility (difficulty conceiving children, in both men and women)</li><li>miscarriage</li><li>menstrual irregularities</li></ul><h3>Body</h3><p>Other celiac disease symptoms that could affect parts of the body include:</p><ul><li>osteopenia (mild) or <a href="/Article?contentid=948&language=English">osteoporosis </a> (more serious bone density problem)</li><li>joint pain</li><li>fatigue</li><li>liver and biliary tract disorders</li></ul><h2>Causes of celiac disease</h2> <p>Celiac disease affects about 350,000 Canadians (roughly 1 in 100). It occurs in people all over the world and at any age. People develop celiac disease because of a combination of a genetic susceptibility and environmental factors. If the two conditions are met, some people will develop the condition.</p> <p>People with a relative with celiac disease or who have certain genetic conditions (such as <a href="/Article?contentid=9&language=English">Down syndrome</a> or <a href="/Article?contentid=869&language=English">Turner syndrome</a>) are at higher risk of developing celiac disease.</p> <p>People who already have one autoimmune condition, such as <a href="/Article?contentid=1719&language=English">type 1 diabetes</a>, are at higher risk for developing other autoimmune conditions, such as celiac disease.</p><h2>How celiac disease is diagnosed</h2><h3>Blood tests</h3><p>Doctors can order blood tests to screen for celiac disease. These blood tests look for immune proteins (called auto-antibodies) that the body has made in response to gluten in people with celiac disease.</p><p>The possible blood tests include:</p><ul><li>Anti-tissue transglutaminase (TTG) antibodies</li><li>Anti-deamidated gliaden peptide (DGP) antibodies</li><li>Anti-endomysial antibodies (EMA)</li></ul><p>Your doctor does not need to order all of these blood tests to screen for celiac disease. </p><p>Depending on the results, your doctor or health-care provider will talk to you about further testing to confirm celiac disease. </p><h3>Upper endoscopy</h3><p>An <a href="/Article?contentid=2472&language=English">upper endoscopy</a> may help confirm the diagnosis. An upper endoscopy is a procedure that allows doctors to see the upper part of your child’s digestive system (from the mouth to the top part of the small intestine). Never start your child on a gluten-free diet before you know for sure whether an upper endoscopy is needed to confirm the diagnosis of celiac disease.</p> <figure class="asset-c-80"><span class="asset-image-title">Upper endoscopy</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_endoscope_EN.jpg" alt="" /><figcaption class="asset-image-caption">During an upper endoscopy, a thin flexible tube with a camera on the end is inserted into the mouth and down the esophagus to look at the esophagus, stomach, and duodenum (top part of the small intestine).</figcaption> </figure> <h3>Biopsy of the small intestine</h3><p>During an upper endoscopy, small pieces of tissue (biopsies) of the small intestine are taken; they will be examined under a microscope. If your child has celiac disease, the biopsy will show changes to villi in the sample from the small intestine.</p><p>Never start your child on a gluten-free diet without first getting a confirmed diagnosis of celiac disease. If a biopsy is done after your child starts a gluten-free diet, your child’s villi may look normal because they will have had a chance to heal since the immune response will have stopped. The biopsy may give a false negative result, which means that the result is negative even though your child has celiac disease.</p><p>Talk to your child’s doctor for more information about screening for celiac disease.</p><h2>Treatment of celiac disease</h2><p>Celiac disease is a life-long condition. There is no cure or medication for celiac disease. The only treatment is a strict gluten-free diet for life. The diet will help with the symptoms and will keep your child healthy.</p><p>Even if your child has no symptoms, once diagnosed your child must follow a strict gluten-free diet for life for treatment of the disease. </p><p>Your child must also limit skin contact with <a href="/Article?contentid=956&language=English">gluten-containing products</a>. Gluten-containing products can include food or non-food items (for example, hand cream). Contact with gluten can trigger skin reactions in some people with celiac disease. It is also possible for people with celiac disease to transfer gluten from their skin to their mouth and gut when they are in contact with gluten, which is not safe.</p><h3>Starting treatment: The gluten-free diet</h3><p>Once gluten is removed from your child’s diet, the small intestine will start to heal. Your child should start to feel better and symptoms should improve after about six months of being strictly gluten-free. </p><h3>Maintaining treatment: Sticking to a gluten-free diet</h3><p>Do not stop the gluten-free diet if your child’s symptoms improve. Your child is feeling better because the gluten-free diet is working. If you stop the gluten-free diet, the symptoms are going to come back and the villi will flatten. Even if your child has no symptoms, stopping the gluten-free diet will damage the villi and any previous symptom is going to return.</p><p>If your child’s symptoms of celiac disease do not improve after six months, contact your doctor.</p><p>These <a href="/Article?contentid=957&language=English">tips and resources</a> can help you and your child stick to a strict gluten-free diet.</p><h3>What happens without a gluten-free diet?</h3><p>Gluten is toxic to people with celiac disease because it triggers an immune reaction even if your child shows no symptoms.</p><p>If your child continues to be exposed to gluten, celiac disease may lead to future health problems including:</p><ul><li>low bone density (osteopenia or osteoporosis)</li><li>some small bowel cancers</li><li>other autoimmune diseases (for example thyroid problems)</li><li> <a href="/Article?contentid=1453&language=English">vitamins and mineral</a> deficiencies because of malabsorption</li><li> <a href="/Article?contentid=2499&language=English">premature delivery</a> if pregnant</li></ul><p>If your child follows a strict gluten-free diet, their chances of getting these conditions become the same as the general healthy population.</p><h2>Monitoring your child’s symptoms</h2> <p>After the diagnosis, no other upper endoscopy is usually needed. Your child will have more blood tests that check anti-TTG antibody levels. As your child continues a strict gluten-free diet, their antibody levels should lower. High antibody levels tell the doctor that your child was probably exposed to gluten. </p> <p>Your child’s doctor will also make sure that your child is growing well. If your child had symptoms at the time of diagnosis, they should improve while on a strict gluten-free diet.</p><h2>When to see a doctor</h2> <p>See your child’s doctor if:</p> <ul> <li>your child’s symptoms remain after more than six months of following a strict gluten-free diet</li> <li>your child’s symptoms worsen</li> </ul> <p>Your child’s doctor may refer you to a dietitian. A dietitian can give you more advice about celiac disease, how to plan a gluten-free diet, and how to get a balance of nutrients while following a gluten-free diet.</p>https://assets.aboutkidshealth.ca/akhassets/IMD_celiac_disease_EN.jpgCeliac diseaseFalse

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