Celiac Disease

Celiac disease is a disorder in the immune system of children or adults. In this disease, the immune system responds inappropriately to a protein known as gluten. This protein is found in different foods like wheat, rye and barley. This inappropriate response of immune system causes damage to the lining of the small intestines which results in difficulty in digestion of food.

Infants and children with celiac disease will eventually develop digestive problems. Common symptoms for infants and children include:

  • Chronic constipation
  • Vomiting

  • Chronic diarrhoea, which can be bloody

  • Fatigue

  • Irritability

  • Malnourishment​

This is because the body fails to absorb the essential nutrients in the body. The abdomen becomes bloated, whereas the legs and hands become excessively thin and buttocks become very flat.

Symptoms in teenagers are different and are not visible unless they have been triggered by emotional stress and mental trauma. Common symptoms include: ​

  • Delayed puberty

  • Irritability

  • Diarrhoea

  • Abdominal pain and bloating

  • Depression

  • Dermatitis herpetiformis (itchy skin rash that looks like eczema or poison ivy)

  • Growth problems

  • Weight loss

  • Fatigue

  • Mouth sores​

​Visit a paediatrician at the Children’s Hospital at The Aga Khan University Hospital as soon as you notice any of the above symptoms. Celiac disorder is mostly confused with Irritable Bowel Syndrome, but our panel of doctors practicing as per international accreditations, are able to make an accurate and prompt diagnosis.
​Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.
Your doctor may request the following test.

  • Complete blood count (CBC): One or more parameters related to red blood cells, white blood cells and platelets might be affected in this condition, giving a clue towards etiology and further diagnostic approach. Therefore, it is an ancillary test in the diagnostic workup of this disease.
  • Urine organic acid: Organic acids are metabolic intermediates that are produced in pathways of central energy production, detoxification, neurotransmitter breakdown, or intestinal microbial activity. Urine organic acid test are done to diagnose inherited metabolic disorders, especially Organic Acidemias and amino acidopathies.
  • Amino acid: Amino acid testing in is done to diagnose inherited metabolic disorders, especially Organic Acidemias and amino acidopathies. Amino acids can be tested in plasma, urine and CSF.
  • Urine Succinylacetone: Urine succinylacetone is tested to diagnose Tyrosinemia type-1.
  • MSUD Profile: MSUD profile is done for diagnosis and monitoring of maple syrup urine disease.
  • Methionine and Homocysteine profile: This profile is done to diagnose and monitor disorders of methionine and homocysteine metabolism.
  • Plasma MMA: this test id done to monitor patients with methylmalonic aciduria.
  • Urine Orotic Acid: this test is done monitor patients with orotic aciduria.

Disclaimer: Kindly consult your physician before getting the above-mentioned tests.

Eliminating gluten from your child’s diet all together is the only way to alleviate symptoms of celiac disease. It might be a little difficult to know which food items do or do not contain gluten, but dieticians at The Aga Khan University Hospital can help you understand how this may be done. Eliminating gluten from your child’s diet will allow his or her small intestines to heal gradually. This, however, does not mean that your child will be able to take gluten again. This is a lifelong disorder and if your child consumes gluten again, this might irritate the small intestines again, and the symptoms will reoccur.

To counter intestinal inflammation, your doctor may prescribe medications.

Besides foods that contain gluten, you'll need to watch out for foods that may have been contaminated with gluten. This is called "cross-contamination." This refers to food that does not contain gluten as an ingredient but that comes into contact with gluten-containing foods. This is most likely to happen at home in your own kitchen — for instance, wheat bread crumbs in the toaster, the butter, or jar of peanut butter. You will have to really work to eliminate all such items from your child’s diet.​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.

The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.