Without stressful gastroscopy: Gentle diagnosis in the event of gluten intolerance
Complaints such as stomach ache or diarrhea occur again and again in children. If such symptoms appear especially after eating certain foods, there could be a gluten intolerance behind them. To find out, gastroscopy was previously necessary. But now there is a gentler diagnosis option.
Diagnosis without stressful intervention
Most children have symptoms like abdominal pain or diarrhea every now and then. Such symptoms can also be an indication of a lifelong autoimmune disease: celiac disease (gluten intolerance). In order to confirm such a suspicion in children and adolescents, gastroscopy was essential for decades. Experts are now reporting that in many cases the diagnosis can be made without this stressful intervention.
About one percent of children are affected
It is estimated that around one percent of children and adolescents in Europe suffer from gluten intolerance to celiac disease.
Eating affected foods that contain the gluten protein cause a reaction of the immune system. This leads to chronic inflammation of the small intestine.
The resulting complaints range from digestive problems with abdominal pain, diarrhea, flatulence or constipation to reduced growth or anemia.
The exact causes that can lead to this intolerance are still unknown.
Celiac disease patients must strictly follow their diet and refrain from eating all foods with gluten for life.
The glue protein is mainly found in cereals such as wheat, rye or barley, but is not only hidden in bread, but is also found in processed foods.
Gluten intolerance often goes undetected
Since the signs of celiac disease are very diverse, gluten intolerance often remains undetected.
For decades, gastroscopy in children and adolescents was essential to confirm the diagnosis of celiac disease.
But a large international study - coordinated by Dr. von Haunersche Children's Hospital of the Ludwig Maximilians University Munich Clinic - has now been able to show that in over 50 percent of cases the diagnosis can be made reliably without this intervention.
The scientists recently published the study results in the journal "Gastroenterology".
Stressful gastroscopy with anesthesia
Children must stay in the clinic during the day for gastroscopy with tissue removal. This is always associated with fears and inconveniences.
But the new "results finally clarify," said Prof. Dr. med. Sibylle Koletzko, Head of Children's Gastroenterology at Dr. von Haunersche Children's Hospital at the LMU Clinic according to a message.
"This saves many children the stressful gastroscopy with anesthesia," said Koletzko, who coordinated the new study with her staff.
"In addition, this leads to considerable cost savings in the health system, since in addition to gastroscopy, the expensive genetic analysis is not necessary."
Symptoms with celiac disease often change
According to Koletzko, celiac disease is also called a chameleon among diseases. This is because the complaints often change.
“Celiac disease is one of the top ten overlooked diseases. It is very common, ”said the expert, according to a message from the dpa news agency.
The researchers had collected data, laboratory and tissue samples from over 700 children and adolescents with celiac auto-antibodies in a total of 33 clinics in 21 countries.
These are antibodies made by immune cells that are directed against your own tissue and can cause inflammation in the intestine.
Reliable diagnosis based on specific complaints and blood tests
The study was able to demonstrate that in many cases a reliable diagnosis can also be made on the basis of specific complaints and blood tests with clear results.
If the blood tests are less clear, however, according to Koletzko, gastroscopy is still necessary.
In the message from the clinic, she advises "affected families to make a diagnosis (with and without gastroscopy) to see a children's gastroenterologist or a pediatrician with additional expertise in gluten intolerance".
Further studies will have to clarify whether children with no obvious symptoms or adults can be diagnosed with celiac disease without a biopsy.
Gluten-free food for healthy people is not recommended
Although a gluten-free diet is not recommended for healthy people, some people avoid the protein because they think this diet is particularly healthy.
"The disease celiac disease should not be confused with the fashion trend" gluten sensitivity "and a self-chosen gluten-free diet, which cannot necessarily be considered beneficial," explained Koletzko in the dpa report.
In some cases, a gluten-free diet is even more unhealthy because important nutrients such as whole grains are missing. (ad)