Sometimes a celiac may be unknowingly ingesting gluten, usually in small amounts. For example, children at school may take bread or some pasta from other non-coeliac children, or mistakes may be made in the school canteen.
Of course, they can also make mistakes with food at home or, during adolescence, because they do not differentiate themselves from the rest of the group, they can accept to take gluten despite the consequences that this entails for their health.
Preventive measures to follow for coeliacs
The Digestive System specialist, the doctor responsible for the patient, should look for signs of an incorrect gluten-free diet.
For this purpose, once a year, or earlier if there are doubts about the correct adherence to the gluten-free diet, this is carried out in the consultation/laboratory:
- A weight and height control: in order to check that the weight and height curve is correct or similar to the previous one.
- Measurement of bone mass by ultrasound: not following the diet properly, ingesting gluten even in small amounts, leads to a loss of bone mass, which is detected in the DBM Sonic osteosonograph.
- Dosage of fat in feces: it is performed with the staining method or fecal near infra red absorption, since a poorly followed diet can lead to an increase of fat in the feces.
- Bio Card Test: if there are doubts after carrying out weight and height control, bone mass measurement and fat dosage in feces, this test is performed to indicate the presence of IgA anti-transglutaminase antibodies if the diet has not been followed correctly, or the absence of such antibodies if the gluten-free diet is well done, with a reliability of 99%.
- These tests allow highly reliable results to be obtained in a few minutes. They are also performed when the parents or the patient doubts that following a gluten-free diet is the treatment they need.
- From the age of 8 years onwards, a Body Composition analysis will be performed to determine the correct distribution of muscle, fat and water. This allows to know the basal metabolism, altered in the anomalies of the thyroid function, and to verify the distribution of the muscle in the 4 extremities and thus to detect if there is danger of scoliosis.
- If the celiac patient has a positive HLA DQ2-HLA DQ8 constellation, the occurrence of type 1 diabetes or thyroid disorders is somewhat more frequent than in the non-celiac population. For this reason, from the age of 6 years or earlier, it is prudent to warn the patient and the family about this risk, as well as to carry out biochemical controls.