儿童哮喘管理指南：写给家长和照护者

Overview

Celiac disease (also spelled coeliac disease) is a chronic autoimmune disorder that affects an estimated 1 in 100 people worldwide. When someone with celiac disease eats gluten—a protein found in wheat, barley, and rye—their immune system attacks the lining of the small intestine. This damage prevents the intestine from absorbing nutrients from food, which can lead to a wide range of short- and long-term health problems.

Signs & Symptoms

Symptoms of celiac disease vary widely from person to person, and some people have no obvious symptoms at all (called "silent" celiac disease). Symptoms can appear at any age, from infancy to adulthood.

• Common digestive symptoms: bloating, abdominal pain, chronic diarrhea, constipation, nausea, and vomiting
• Non-digestive symptoms: persistent fatigue, iron-deficiency anemia, skin rashes (dermatitis herpetiformis), joint pain, brain fog, headaches, infertility, and missed periods
• Symptoms in children: delayed growth, delayed puberty, enamel defects on permanent teeth, and irritability

Causes & Risk Factors

Celiac disease is caused by a combination of genetic and environmental factors. You must carry one of two specific gene variants (HLA-DQ2 or HLA-DQ8) to develop the condition, but not everyone with these genes will get celiac disease. Gluten consumption triggers the autoimmune reaction in people with the genetic predisposition. You are at higher risk for celiac disease if you have a first-degree relative with the condition, another autoimmune disorder (such as type 1 diabetes or rheumatoid arthritis), Down syndrome, Turner syndrome, or selective IgA deficiency.

Diagnosis

Diagnosing celiac disease requires specific testing, and it is important to continue eating gluten until all tests are completed to avoid false negative results. First, your doctor will order blood tests to check for celiac-related antibodies. If blood tests are positive, you will likely need an upper endoscopy, where a small sample of tissue is taken from your small intestine to check for damage. In some cases, genetic testing may be used to rule out celiac disease if your blood test results are unclear.

Treatment & Management

There is no cure for celiac disease, but the condition can be fully managed with a strict, lifelong gluten-free diet. This stops the immune attack on the small intestine, allows it to heal, and prevents symptoms and long-term complications. Your doctor may also recommend supplements to correct nutrient deficiencies (such as iron, calcium, vitamin D, and B vitamins) and medications to manage symptoms or related conditions like dermatitis herpetiformis.

• Avoid all sources of wheat, barley, and rye, including hidden gluten in processed foods, sauces, salad dressings, and medications
• Look for products labeled 'gluten-free certified' to ensure they meet safety standards for gluten content
• Prevent cross-contamination at home by using separate toasters, cutting boards, and cooking utensils for gluten-free foods, and thoroughly clean surfaces before preparing gluten-free meals
• Work with a registered dietitian who specializes in celiac disease to create balanced meal plans and ensure you are getting all necessary nutrients

Living With It

Most people start to see improvement in their symptoms within 1 to 2 weeks of starting a gluten-free diet, though full intestinal healing can take 6 months to several years. With careful planning and support, most people with celiac disease live full, healthy lives. It is important to read food labels carefully, communicate your dietary needs when eating out, and connect with other people living with celiac disease for support and practical tips.