One in five children with celiac disease would not respond to the only real treatment for this condition: the gluten-free diet. Boston University researchers followed 103 children and adolescents diagnosed with celiac disease, which causes many intestinal symptoms, including bloating, nausea, and abdominal pain. These manifestations are a reaction of the body to gluten, present in particular in wheat and other cereals. The general population digests this element very well, but not sick people. The main management of the disease is therefore to eliminate any gluten intake in the diet. This gluten-free diet was followed on average by children for 2.4 years, and strictly by 90% of them.
Abnormalities present even after symptoms disappear
At diagnosis, then a year after the implementation of the diet, the scientists carried out endoscopy and intestinal biopsy examinations. For the first, it is a question of exploring the interior of the digestive system. The second is to collect and analyze gut samples. In addition, lgA tTG antibodies, typical of the disease, were measured. Children who had persistent or even new symptoms underwent these examinations several times to follow the evolution of the disease.
Result of the study: even when the symptoms improve or the level of antibodies is good, 19% of the children retain abnormalities in the intestine visible thanks to the examinations of exploration. Performing repeated biopsies is not recommended in the management of this pathology, but for the authors, their study shows that it is the only way to verify that the intestinal abnormalities have indeed disappeared after the diet without gluten. It is now for them to continue their work in order to better determine the role of gluten and to understand what happens when it is excluded from the diet.
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