EXPERT ADVICE My child is gluten intolerant ― does he have coeliac disease?

Wise up to facts about gluten intolerance and coeliac disease. Plus, an expert has suggestions on supplementing your child’s diet.

Tots-My-child-is-gluten-intolerant–does-he-have-coeliac-disease
More and more celebrities are extolling the benefits of a gluten-free diet, which has become popular in recent years.

In fact, Hollywood leading ladies like Gwyneth Paltrow and Jessica Alba swear by a gluten-free diet because it benefits their health or they are intolerant to this protein that’s found in whole grains. Those who support a gluten-free diet say it reduces inflammation, the diabetes risk and even heart disease, among other pluses.

Yet, many health studies prove that the reverse is true — increasing your consumption of whole grains, which contain gluten, actually lowers the chances of heart disease, stroke and type-2 diabetes. In fact, gluten is actually a prebiotic that feeds the good bacteria in your body.

So, you shouldn’t restrict your tyke’s consumption of gluten products — such as wheat, barley and rye — unless they have a gluten intolerance or coeliac disease. Gluten is found in pasta, ramen, bread, crackers, cereal and granola.

Professor Quak Seng Hock, head and senior consultant at the Division of Paediatric Gastroenterology, Nutrition and Hepatology at the National University Hospital, notes that even though both gluten intolerance and coeliac disease are thought to be similar — these are two separate issues.

If your child suffers from a gluten intolerance, they may experience symptoms such as bloating or stomach discomfort after taking food containing gluten, Prof Quak explains.

Coeliac disease, on the other hand, results in symptoms such as chronic diarrhoea, oedema and enteropathy — a disease of the small intestine. If your offspring has the disease, the mucous membrane of their small intestines will also appear inflamed.

In both cases, the symptoms usually show up after sufferers consume a meal that contains wheat products such as bread or pasta. Prof Quak has expert insights on gluten intolerance and how coeliac disease is treated:

“For coeliac disease, the long-term effect is obvious: Severe malnutrition and failure to thrive — a term used to refer to your child’s insufficient weight gain.”

How common is gluten intolerance or coeliac disease among kids in Singapore?
We hardly see any coeliac disease in the local population. The occasional coeliac disease that we encounter involve Caucasian children whose parents are working in this part of the world. Non-coeliac gluten intolerance is another [health issue] that we do see on and off in both the local and foreign population. The number of patients is not big and the exact number is not known.

What tests are carried out to diagnose these two conditions?
For coeliac disease, serological tests — blood tests to detect the presence of certain antibodies — are carried out more often, in recent years. These tests include anti-gliadin antibody, anti-endomyceal antibody and anti-transglutaminase antibody tests. A specific genetic test can also be done for coeliac disease. On the other hand, there is no reliable test for non-coeliac gluten intolerance. To be certain about the diagnosis, the best way is to do a placebo food challenge.

There is a lot of buzz online that a gluten-free diet is good for overall health and wellness and that it even alleviates autism symptoms in children. Is this true?
There is no scientific proof for this claim, especially for alleviating autism symptoms.

Is keeping gluten out of our kids’ diets the only solution for gluten intolerance?
For food intolerance, the best treatment is to abstain from the offending food.  Hence, it is of great importance to be certain in making the diagnosis [by going to a trained medical professional].

Any long-term health issues that can result from a gluten intolerance and coeliac disease?
For coeliac disease, the long-term effect is obvious: Severe malnutrition and failure to thrive — a term used to refer to your child’s insufficient weight gain. However, whether the patient with non-coeliac gluten intolerance would have long-term health issues is uncertain.

How can parents supplement their kid’s diets if they are gluten intolerant or have coeliac disease?
Wheat is not an essential food item. It’s a carbohydrate and can be replaced by other carbohydrate items such as rice, potatoes or corn.

Photo: iStock

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