CELIAC DISEASE, is a chronic disorder of infants and children characterized by an impaired absorption of food materials. The major symptom is diarrhea, and the stool is generally fatty, bulky, and foul-smelliing. Associated with the diarrhea is a loss of nutrients, leading to nutritional deflciencies. The major problem is concerned with the malabsorption of fat.
For many years, the cause of celiac disease was unknown, but it is now recognized tlıat afflicted patients are usually sensitive to certain proteins, called glutens, which are found in wheat, rye, and oats. There is some evidence suggesting that the disease is due to an inherited defect of some kind, but the exact mechanism is stili unknown. Celiac disease occurs almost exclusively in white children. It is uncommon in Negroes and has never been found in Orientals. In recent years, a malabsorption disorder of adults has been recognized as a sensitivity to glüten. This disorder, once called non-tropical sprue, is now called adult celiac disease.
Symptoms. The severity of celiac disease may vary enormously, from a mild digestive distur-bance to a serious and debilitating wasting disease. The onset usually occurs gradually at the end of the first year of life and becomes full blown in the second year. In addition to the diarrhea, the child often has a poor appetite and does not grow normally. He may also become irritable and moody. As he grows older, retarda-tion in growth and development becomes more evident, and there is a weight loss, usually most marked in the limbs and around the buttocks and groin. Although the face often remains full and plump, the child often looks pale, and there may be a puffiness around the eyes. The abdomen is generally enlarged and distended.
Treatment. Treatment consists of placing the child on a gluten-free diet. If this diet is strictly followed, there may be a complete remission of the symptoms, and by the replacement of lost nutrients ali signs of deflciency disappear. Most children improve spontaneously in adolescence and adult life, although there may an occa-sional later recurrence.