The gliadin portion of gluten provokes an autoimmune response in small intestine, leading to villous atrophy, flattening of the mucosa, and a reduced ability to absorb nutrients from food. There is a certain heritability to the disease, with a 1/10 chance of developing it, if a first degree relative has it.
Typically begin at 8–24 months when the child is weaned onto gluten-containing foods, however it is most commonly diagnosed in adults between the ages of 40 and 50. Children:
- Weight Faltering
- Abdominal distension
- Mouth ulcers
- Abnormal stools- pale, loose, steatorrhoea.
- Fat soluble vitamin deficiencies- A,D, E and K.
- Intermittent abdominal pain
- Excess flatulence
- Weight loss
- IgA transgluaminase antibodies as a screen
- Endoscopy with small intestine biopsy:
- Villous atrophy
- Crypt Hypertrophy
The only solution is a Gluten Free diet. Failure to comply can lead to relapse of symptoms.
- Avoid wheat, rye, barley
- Gluten challenge later in life, to confirm diagnosis