What is Celiac Disease: Celiac disease is an intestinal disease of an autoimmune nature that occurs in genetically predisposed individuals due to the effect of gluten, that is, when our own immune system cells react against our own intestinal cells.
It is caused by the inability of individuals who are genetically prone to autoimmunity to digest the gluten substance found in some grains. The person's own immune cells attack the indigestible gluten particles and the enzymes involved in digestion, thus triggering an inflammatory process that will continue in series. As a result of these reactions, the brush-like structure in the intestine, which is responsible for the absorption of nutrients, is damaged, becomes shorter, and gradually the intestinal surface becomes completely flat and loses its absorptive capacity.
What are the symptoms? Celiac disease has symptoms related to the gastrointestinal system as well as symptoms outside the gastrointestinal system. In the classic type, diarrhea, abdominal bloating, abdominal pain, melting of subcutaneous fat tissue and growth retardation are obvious symptoms. However, today, most cases present with symptoms of anemia, osteoporosis, dental disorders, elevated liver enzymes, joint pain, gait disturbance in the form of ataxia, constipation and rarely seizures/convulsions. Since the disease is created by the person's own immune cells, it can be accompanied by diseases such as Diabetes, Thyroid gland diseases, psoriasis and some other skin diseases, which develop through this mechanism, as well as chromosomal disorders such as Down syndrome and Turner syndrome.
How is it diagnosed? First of all, Celiac markers are checked in the blood of clinically suspected individuals. In individuals with one or more of these markers positive, the diagnosis is made by performing a small intestine biopsy.
Which tests are checked? If your child has clinical findings suggestive of celiac disease or one of the diseases that like to be associated with celiac disease, some markers such as antigliadin, anti-tissue transglutaminase, anti-endomysium or deaminide gliadin are examined in addition to routine blood tests, and according to the results, an upper endoscopy is performed and a small intestine biopsy is taken.
How is it treated? The only and definitive treatment of the disease is a lifelong Gluten-free diet.
What is the Course of the Disease? When people fully comply with the diet, they live with the same quality of life as other members of the society.
Nutritional Disorder:
What is a Nutritional Disorder?
A If the child cannot get the recommended amount of nutritional needs necessary for growth for at least 1 month, this is called malnutrition. Nutritional disorders develop depending on the child, family and environmental reasons. Child-related causes may be due to organic causes such as chewing and swallowing disorders, digestive system, respiratory tract diseases, neurological disorders, or behavioral causes such as infantile anorexia, traumatic feeding disorder or sensory feeding disorder. It should not be confused with Neophobia, which is described as physiological.
What are the symptoms? Food rejection, loss of appetite, food leakage into the airways, difficulty swallowing, keeping food in the mouth, vomiting, food coming through the nose, growth retardation, weight loss, symptoms related to vitamin and mineral deficiency may be observed
How to Diagnose? When you apply with a feeding disorder, your child is first evaluated in terms of general health problems and nutritional status by a team including Pediatric Gastroenterology, Child Psychiatry, Language and Speech therapist and Dietician. It is examined in accordance with the preliminary diagnosis made with the help of history and physical examination.
Which Laboratory Tests are performed? In addition to routine blood tests, vitamin and mineral measurements are made specific to the case. Videofluoroscopy, USG or EMG evaluations are performed for patients with suspected swallowing disorders. In cases thought to be related to the esophagus or digestive system, upper endoscopic evaluation or motility studies are required.
How to Treat? While our children who are thought to have behavioral disorders are treated accordingly, we also aim to catch up with their peers by providing them with the necessary nutritional support. Those diagnosed with organic disorders are treated for the relevant disease.
What is the course of the disease? The clinical course varies depending on the organic cause found. The majority of our children who do not have any obvious organic problems achieve nutrition appropriate to their peers through psychiatric treatment and physiotherapy.
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