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Celiac Clinic

Celiac Disease Clinic

The Celiac Clinic at Children’s Hospital & Medical Center is the only pediatric clinic of its type in the area. Our multi-disciplinary team works with you and your child to help successfully develop a gluten-free diet that will eliminate the negative symptoms of celiac disease.

What is Celiac Disease?

Celiac disease is a digestive condition caused by sensitivity to the protein gluten.  The gluten triggers an immune reaction, which causes the body to create antibodies to get rid of it. This can result in damage to the small intestine, reduced absorption of important nutrients and long-term complications. 

It is estimated that more than 3,000,000 people in the United States are affected by celiac disease, but only 150,000 have been diagnosed. Celiac disease often occurs in children who are affected by type 1 diabetes, Williams syndrome, Down syndrome, selective IgA deficiency, Turner syndrome and those who have first degree relatives with celiac disease.

Seeking early diagnosis and treatment for celiac disease is important to prevent long-term complications. Malabsorption of nutrients can cause vitamin deficiencies that can lead to stunted growth in children, osteoporosis, folate and iron deficiency, and kidney and liver issues.

Symptoms

Celiac disease can be difficult to diagnose because there are no “typical symptoms” and many of them mimic other gastrointestinal problems. Up to one-third of children have clinically silent disease and another 40 percent have atypical symptoms. 

When symptoms do occur, they are often related to the gastrointestinal tract. These may include:

Gastrointestinal Symptoms:

Diarrhea with failure to thrive
Abdominal pain
Vomiting
Constipation
Abdominal distention
Irritability

Non-gastrointestinal symptoms:

Dermatitis herpetiformis
Dental enamel hypoplasia of permanent teeth
Osteoporosis
Short stature
Delayed puberty

Iron-deficient anemia - resistances to oral iron

Diagnosing Celiac Disease

Blood tests are used to determine who is likely to have celiac disease. If the test is positive, this is followed by an endoscopic small bowel biopsy, which can reveal the severity of your child’s condition and help doctors better manage the disease.

The diagnosis of celiac disease is considered definitive when all of your child’s symptoms have been resolved after adhering to a strict gluten-free diet.

Treatment

Celiac disease can be effectively managed by following a gluten-free diet.  This diet needs to be followed for a lifetime, even after symptoms have disappeared. Ingesting even small amounts of gluten can lead to problems with the intestinal tract.

When your child follows a gluten-free diet, treatment follow-up will be minimal.  Follow-up will include periodic visits for assessment of symptoms, growth, physical examination and adherence to the gluten-free diet.

A gluten-free diet involves avoiding any ingredient derived from wheat, rye, oats, barley or malt.  This also includes non-food products such as cosmetics, lotions, personal care products, and envelope glues, to name a few.  Read labels to ensure the product is gluten free. 

Foods to Avoid

Wheat - All kinds, including spelt, kamut, einkorn, durum, semolina, triticale and atta; and all forms, including wheat bran, couscous, graham flour, matzo, wheat germ, cracked wheat, farina and tabbouleh.
Rye
Barley - All forms, including malt, malt flavoring, malt extract, malt syrup and malt vinegar.
Untested oats
Any ingredient derived from wheat, rye, oats, barley or malt.  Read labels to ensure these five words are not included in the ingredients.

Foods Recommended

Gluten-free grains - arrowroot, bean flours, buckwheat, cassava, corn, flax, millet, nut flours, potato, quinoa, rice, salba, sorghum, soy, tapioca, wild rice and yucca.
Milk and milk products - All types
Meat and other protein foods - fresh meat, fish, poultry, eggs, aged cheese, unprocessed nuts and seeds.
Vegetables - dry beans, peas, lentils
Fruits - all fresh fruits
Fats and oils - vegetable oils, butter

Our Staff
Pablo Palomo, MD
Benjamin Infantino, MD
Megan Enenbach, APRN-NP
Shawnie Davis, RD, LMNT
Emilie Beltz, RN,BSN

© Children's Hospital & Medical Center | In Affiliation with University of Nebraska Medical Center College of Medicine