Bonnie Lynn Mechanic Celiac Disease Clinic
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About Celiac Disease
Celiac disease, also known as sprue or gluten-sensitive enteropathy, is an autoimmune, genetic, permanent condition in which the small intestine is damaged as a result of exposure to gluten. Gluten is a protein found in wheat, rye and barley. The small intestine is lined with tiny finger-like projections, called villi that help to digest and absorb nutrients from food. It is thought that the gluten triggers an immune reaction, which causes damage to the small intestine and villi and interferes with the body's ability to digest and absorb nutrients.
Symptoms in children can include:
- Diarrhea with failure to thrive.
- Abdominal pain.
- Vomiting.
- Constipation.
- Abdominal distention.
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| Text taken from Going Gluten-Free pamphlet with permission. | Screening for celiac disease is recommended for children with:
- Diarrhea and failure to thrive.
- Chronic GI symptoms such as abdominal pain, poor appetite, constipation and vomiting.
- Short stature.
- Delayed puberty.
- Dermatitis herpetiformis.
- Dental enamel defects on permanent teeth.
- Iron-deficiency anemia outside of infancy.
- A parent or sibling with celiac disease.
- A condition that puts the child at increased risk of having celiac disease. This includes:
- Down Syndrome.
- Type I Diabetes.
- Autoimmune Thyroiditis.
- Turner Syndrome.
- Williams Syndrome.
- Selective IgA Deficiency.
How is screening done?
Screening only can be done if the child is currently eating foods that contain gluten (most bread, crackers, noodles and pasta). Screening involves a simple blood test in which antibodies to gluten are measured. The recommended test is for the antibody tissue transglutaminase (TTG). A measurement of total IgA is also recommended to help with the interpretation of the lab results.
What happens if the serum TTG is abnormal?
If the serum TTG is elevated, a test called an endoscopy is needed to make a final diagnosis of celiac disease. An endoscopy is a procedure done by a gastroenterologist. Tiny tissue samples, called biopsies, are taken from the small intestine. The pathologist then exams these tissue samples under a microscope and reports back to the gastroenterologist. This is the only true way to diagnose celiac disease.
What is the prevalence of celiac disease in the United States?
- In children between the ages of 2 ½ and 15 years: 1 in 300 to 1 in 80.
- In average healthy people: 1 in 133.
- In people with related symptoms: 1 in 56.
- In people with first-degree relative (parent, child, sibling) with celiac disease: 1 in 22.
What is the treatment for celiac disease?
The treatment for celiac disease is a strict, life-long, gluten-free diet. Once a diagnosis of celiac disease is made, the next step is referral to a dietitian who is knowledgeable in the gluten-free diet.
Because of the complexity involved in reaching a final diagnosis and the indepth education required after the diagnosis is made, children should be referred to a program with the facilities and expertise for investigation and treatment. The Bonnie Lynn Mechanic Celiac Disease Clinic at Children's Hospital of Wisconsin is one such place.
Bonnie Lynn Mechanic Celiac Disease Clinic
The Bonnie Lynn Mechanic Celiac Disease Clinic uses a multidisciplinary approach to treating children and families with celiac disease. The clinic is staffed and led by board-certified pediatric gastroenterologist, Grzegorz W. Telega, MD. The team consists of a pediatric gastroenterologist, nurse and nutritionist.
Each physician partners with a nurse to provide ongoing case management. As education on diet and nutrition is key to managing celiac disease, Elaine Danner, clinical dietitian specialist, is an integral part of the care team and a resource for patients diagnosed with celiac disease and their families.
Your child's first visit to the clinic will take about 30 minutes to one hour. The visit will include a physical exam and review of your child's past and present medical history. Please come prepared to discuss your overall family health history. Following the visit, the team may recommend some screening laboratory tests. If the initial screening is positive, a recommendation may be made for future testing to accurately diagnose the disease.
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