We had six children with celiac disease at camp last week. Four are scheduled this week. Collectively, this is the largest number of gluten-sensitive children we’ve ever had at camp. It raises some challenges for our dietitian. The camp is not designed to be gluten-free, but will accommodate children with celiac disease if their parents are able and willing to bring in specially prepared gluten-free foods and snacks.

The ADA recommends screening children with type 1 diabetes for the presence of celiac disease. The rationale is that since celiac disease is an autoimmune condition with a frequency of around 1 in 4000 persons, that its relative risk would be higher in persons with another autoimmune disease, type 1 diabetes.

It was interesting to see the spectrum of this disease as far as how seriously each celiac camper had to adhere to the special diet. Since celiac itself evolves over time, this is one obvious explanation. However, when operating a children’s camp, we must generally assume the worst case scenario as far as how strictly gluten should be avoided in the diet of these youngsters. We can’t pick favorites. Some campers told us they often eat gluten-containing foods without any stomach or intestinal problems. Yet others get seriously ill when even a small amount of gluten-containing croutons touches their salad.

Type 1 diabetes is not that different in its clinical course. It’s not an “all or none” disease in how it evolves clinically. Remember the honeymoon phase? Celiac disease follows a similar path which can explain why some are more significantly affected than others. We’ve asked all celiac families to bring their children’s food with them on the first day of camp. Our staff will prepare these foods in place of what is served in the dining hall. Failure to bring special foods will result in an opportunity to go into town and purchase these items and return with them in time to enroll their camper. If not, the camp isn’t able to purchase and individually prepare meals suitable for celiac patient consumption.

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This entry was posted on Sunday, July 27th, 2008 at 2:00 am and is filed under Camp. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.