Hi. I am Dr. Sushma Narayan. I am a Pediatric Gastroenterologist working in New Delhi. I have a dedicated clinic for celiac disease. Friends today I will be talking to you about celiac disease. Many of you may not have heard of celiac disease very much or you may know who is suffering from celiac disease. Now what is celiac disease? Celiac disease is a sort of wheat allergy or intolerance to wheat. More and more people are now coming to understand this disease to know that yes celiac disease exists and this is due to ingestion of wheat. Now there is a substance called gluten in wheat and barley and also a European grain called rye. Now when a person injects wheat which has gluten in it there is, the person starts suffering from some sort of discomfort may be stomach ache, or you know the need to go to the toilet, or some sort of nausea or vomiting. Now these are, these may be the initial symptoms. However in children the most predominant symptoms are diarrhea, chronic diarrhea, then severe anemia which is not responding to iron therapy. Severe iron deficiency and growth failure. These are the 3 hallmarks of celiac disease in children. We often pick up this disease around 4 to 5 years. Thereby showing that, yes the delay in diagnosis does occur in the disease. It;s not very easy to diagnose as a list of suspicion has to be very high when you are thinking of celiac disease, also there is a presentation which is called as Atypical presentation. Now in Atypical presentation need not have any of these symptoms but may just come to you with some thyroid issues., maybe some skin allergies or the patient may come to you simply with a diabetes mellitus. Insulin-dependent diabetes mellitus. So we have to really start thinking that is it really possible for a person to have wheat intolerance or all these symptoms. Yes it is true. But how does it come? How does this disease comes. Due to a genetic predisposition when the HLA dilute to or HLA due to 8 genes are present. We too are testing for this genes and if the patient is negative for these genes, it is said that they cannot celiac disease. In addition we have to very sensitive, psychology test, which one is called the anti TTG IGA and the second test is the anti Endomysial antibody tests. The TTG test is very easily available and comparatively cheaper test and it has a very high sensitivity and specificity. Once the TTG is positive then we also check out the family history. Is there any family history of wheat allergy or tolerance in the family and then request the patient to undergo an upper GI endoscopy along with a biopsy. Biopsy specimens are taken and these are examined and if the demonstrate that the will I have got damaged and there is a flat mucosa or there is a partial vilosetrophy then the diagnosis of the celiac disease is confirmed. Once the diagnosis of celiac disease is confirmed then we have to stop wheat. But prior to that a complete assessment of the patient has to be done with regard to the thyroid status, the liver enzymes have to be checked out and also the patient has to be thoroughly checked for other vitamins deficiencies like Vitamin D, Vitamin B complex and iron. And accordingly the supplementation has to be started. Now can these patients can take a little bit of wheat? No, unfortunately its not, because once the wheat allergy diagnosis that is a celiac disease that is established they cannot take even minuscule amount of wheat. The codex the national cortex elementary says that these patients cannot take more than 20 parts per million. However lot of food, glutton free food is available in the market which is not tested, which is not labeled properly, but these patients are compelled to use these foods. And these are highly containiated to treat which means that this patient never get into full recovery. So the issues here are that once we have found the patient is suffering from celiac disease we have to now help the patient to regain his full potential by stopping wheat completely and doing a regular follow up with the doctors to see if the patient compliance is good, if the glutton tree diet is completely, complete in all ways. Like its neutraionaly complete. So that the patient recovers completyly. And we, lot of Gastroenterologist are offering advice on celiac disease. We are working in Delhi. And if any of you need any consultation regarding this disease, please contact me through Lybrate or on my address which is celiac clinic, B13. Shiwalick malvic nagar. New Delhi.
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Treatment of Child and Adolescent Problems
Treatment of Childhood Infections
Child Nutrition Management
Growth And Development Including General Paediatri
Management of New Born Care
Treatment of Thyroid Disease in Children
Management of Childhood Nutrition
Child Growth Management
Management of Postnatal Care
Treatment of Newborn Jaundice
Lower/Upper Respiratory Tract Infection Treatment
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Patient Review Highlights
It was getting very difficult for me to cope us with caring for my son. I am so thankful that Sushma Narayan has given me the best advice and my child is now finally able to get back to my normal self. Even though there was a long queue, still the staff was very pleasant. My problem was such that it required a number of sessions, and I must say after all the sessions, I am feeling much better now. I found the the Celiac Clinic itself quite pleasant. No matter how critical be the situation, she is always very calm. Sushma Narayan is well aware about innovative techniques to treat problems.
My son was suffering from body weakness. Initially the symptoms of body weakness were not that severe but then it became worse. I chose to consult Dr Sushma Narayan. she is not just friendly, but also is very motivating. My boss referred me Dr Sushma Narayan. I must say the hygiene was maintained very nicely in the the Celiac Clinic . I was quite concerned, as my son's health was degrading day by day, but due to Dr Sushma Narayan and the body weakness treatment I didn't lose hope. Dr Sushma Narayan is quite knowledgeable.
Thanks to the expert care and guidance, my son feel much better than before. Even in case of long queues, the staff was managing people in a very positive manner. she is not just highly qualified, but has years of experience in handling high risk cases. I thought it was something very normal, but then I realised it is celiac disease. Sushma Narayan is really like god send person.
she ensures that she gives enough time to each patient. I was in so much pain due to my cold cough. I read about the Sushma Narayan on one of the social media platform. Sushma Narayan has so much knowledge that for everything my family takes her reference. I was admitted to the the Celiac Clinic in Delhi in case of emergency, but not once did any of the nurses panicked.
i refer to Dr. Sushma Narayan for caring for children. the atmosphere in the the Celiac Clinic is always so positive and full of life. One of my cousin's referred to Sushma Narayan. Not only she is very calm and composed, but is also a very understanding doctor. Sushma Narayan doesn't just randomly prescribes medicines, but first properly diagnoses the problem.
Sushma Narayan is really like god send person. Sushma Narayan doesn't just randomly prescribes medicines, but first properly diagnoses the problem. The entire The Celiac Clinic was spotlessly, clean. The Celiac Clinic had all the amenities, a patient requires. The dog bite treatment she gave my son has helped me greatly and now She is perfectly fine.
My child was suffering from excess coughing. I visited to the Celiac Clinic to meet Dr Sushma Narayan. the treatment she gave was quite beneficial. I thank her for the help and prescribing the right medication for coughing treatment.
My child was suffering from excess coughing. I visited to The Celiac Clinic to meet Dr Sushma Narayan. The treatment she gave was quite beneficial. I thank herfor the help and prescribing the right medication for coughing treatment.
Dr. Sushma Narayan provides answers that are very helpful, knowledgeable, thorough, well-reasoned and sensible. Excellent, the doctor seems to be extremely knowledgeable and expert in her profession, many thanks.
Dr. Sushma Narayan provides answers that are knowledgeable. Hello Mam, Thank you so much for the reply. Baby got discharged and she is doing better now. But still i hear some gurgur sound when she breath.
I found the answers provided by the Dr. Sushma Narayan (Aiims) to be very helpful. Ok doctor.thanks a lot.
I found the answers provided by the Dr. Sushma Narayan to be very helpful. Thank you mam...
Dr. Sushma Narayan (Aiims) provides answers that are very helpful. Thank u...
An infant is usually called a bundle of joy and with good reason. There are simple and carefree, and bring a smile to your face with their antics. However, the mood and health of an infant can be tarnished due to an issue which is known as galactosemia.
What is Galactosemia?
When a baby has galactosemia, he or she will have a problem when it comes to digesting galactose, which is something that is present not only in milk but in all milk products. Galactose is a sort of sugar, just like fructose and glucose is. As a matter of fact, lactose, which is what milk has, is, in fact, a combination of glucose and galactose. Also, when lactose is processed, it is broken down by the human body into its constituents.
The condition is something that is passed down through the genes of the parents of the baby. The condition would occur if the gene which causes a tendency for a baby to have galactosemia is present not only in one parent but both of them. A baby who has the condition will be lacking an enzyme which is known as the GALT enzyme. The enzyme could also not be functioning as it should be under normal circumstances.
When it comes to the problem, it is very important, to say the least, to detect it sooner rather than later as if there is a build-up of unprocessed galactose which is allowed to occur, it can affect the baby adversely and in some cases, it can also be threatening to the life of the baby!
How does it affect a baby?
The problems which can erupt due to galactosemia include issues which affect organs such as the brain, eyes, liver and kidneys. It is interesting to take note of the fact that these are all organs which either have something to do either processing the blood or are heavily dependent on it. While a baby is not in the position in which he or she can communicate the issues that are being faced, when keeping an eye out for galactosemia, the signs which are displayed include an irritability of the baby as well as lacking consumption of the milk of the mother.
Even though galactosemia may not be the case, a doctor should be consulted as the exacerbated issue can include seizures and jaundice. It is to be kept in mind that galactose is something that can be found not only in the milk of the cow but also human milk as well as the milk of other animals such as goats.