Celiac Disease (CD) is an autoimmune disorder that causes inflammation and damage to the lining of the small intestine. When a child with CD eats gluten, which is most often found in wheat, rye and oats, his or her immune system reacts. The reaction creates damage to the lining of the intestine and prevents it from properly absorbing nutrients. As a result, children suffering from CD may also become malnourished despite the quantity or quality of food they eat. Symptoms of CD are not the same for every sufferer and can include abdominal pain, bloating, gas, diarrhea or constipation, nausea and vomiting.
CD can affect anyone regardless age, race, or gender; however, it affects children, Caucasians and people of European descent more than others. There are a number of characteristics identified as CD risk factors by Dr. Benjamin Lebwohl, along with a group of researchers at the Celiac Disease Center at Columbia University in New York. The Journal of Clinical Gastroenterology and Hepatology recently published their findings, “The Unfolding Story of Celiac Disease Risk Factors.”
Genetics and Other Autoimmune Disorders
CD is genetically based. If you have a close relative with CD, such as a parent, sibling, grandparent, aunt or uncle, you are also at risk for developing the condition.
In addition to familial factors, genetic markers can identify children most at risk for developing CD. About 90 percent of people diagnosed with CD have the genetic marker HLA-DR3-DQ2. The majority of the remainder have the genetic marker HLA-DR4-DQ8. These are not the only celiac markers, but are the main two. The more markers a child has, the more at risk he or she is for developing CD.
Children suffering from other autoimmune disorders, such as Lupus, thyroid disease or Type 1 Diabetes, are also likely to suffer from CD.
Certain Infections, Antibacterial Medications and Hygiene Hypothesis
Certain infections, such as rotavirus and campylobacter, have been associated with increased risk for developing CD. But since these particular bacterial viruses do not currently occur at a high rate, scientists have focused on the association between decreased exposure to bacteria and increased incidence of CD. In other words, the fact that households have antibacterial soaps and antiseptics readily available may be contributing to children developing CD and other allergic illnesses. The take away? Let your kids get a bit dirty.
The same is true of antibiotic use. Certain antibacterial medications, including antibiotics, and proton pump inhibitors (generally used for acid reflux such as Prilosec or Prevacid) have been associated with increased risk for developing CD.
Infants born via elective cesarean section may be at higher risk for CD. During vaginal childbirth, and where cesarean occurs after initial contact with the birth canal, infants are exposed to microbes that affect the bacterial framework of their intestinal tract. In theory, the change in the bacterial framework decreases the risk of CD in infants delivered via the birth canal.
Good bacteria and bad bacteria may not be in balance in those delivered via elective cesarean. Low levels of the probiotic (good bacteria) “bifidobacterium” have been detected in the digestive tracts of people suffering from CD. However, no in-depth studies have been conducted evaluating probiotics and CD.
Infant Feeding Practices and Maternal Iron Supplementation
Scientists discovered two CD epidemics in the 20th century. Both showed evidence that when the incidence of breast-feeding declined, the rates of CD rose. And at the time of each epidemic, the levels of gluten in formula were also high. The belief was that infants who were weaned early, or not breast-fed at all, received formula that contained gluten. Further investigation established that it was not necessarily breast-feeding that was most associated with the development of CD, but the timing of gluten introduction to children that is essential to establishing risk. Apparently, if gluten-free formula is available, it’s a better option to prevent premature introduction of gluten to infants.
Additionally, infants whose mothers took iron supplements during pregnancy appear to be at higher risk for CD than those who did not. Studies show excess iron may lead to immunodeficiencies in infants. However, they have not established that exposure while in the womb has consequences after birth; excess iron may be associated with, but not the cause of, CD. More studies are needed to determine the connection, if one exists, between iron supplementation and CD. So don’t stop the supplements just yet, unless advised by your physician.
Being at risk for CD does not mean your child definitely has or will ever develop the disease. It simply means he or she is more at risk than others are. Studies have shown there are generally three steps to developing CD: having one of the genetic markers, ingesting gluten and an environmental factor, which has not yet been identified.
If your child has been diagnosed with CD and experienced gastrointestinal damage, following a gluten free diet for three to six months can repair the damage. Living gluten free can help prevent any further damage to your child’s digestive system.