Like her classmates, nine-year-old Eliza loves a birthday party – but a slice of the cake is rarely on the menu.
Her coeliac disease diagnosis four years ago means she has to avoid any food containing gluten, a dietary protein found in wheat, barley and rye, or, as her mum Selina, from Blackburn, Lancashire, puts it, « all these really delicious foods she can no longer have ».
However, her classmates have rallied round.
« I think it’s pretty nice because, especially when it’s someone’s birthday and they’re giving out cakes, they wouldn’t just leave me out. They’re good friends and they give me a full packet of Haribo, » said Eliza.
The unremittingly positive little girl described her symptoms before she was diagnosed as « belly aches and everything, and I felt sick but other than that, I just felt like a normal person ».
Selina had been so concerned about her daughter she asked for a blood test; doctors thought she must have irritable bowel syndrome.
So it was a relief when Eliza was finally diagnosed with coeliac disease, which affects one in 100 adults and children.
« As soon as you are diagnosed with coeliac disease, you can start a strict gluten-free lifestyle, and that allowed Eliza to be herself and live, » said Selina.
However, she said she had experienced fear and irrational guilt after Eliza’s diagnosis.
« You find yourself asking, ‘did I eat the wrong things when I was pregnant?’
« You start worrying then, you know, ‘are there foods out there that she’s going to enjoy? Are there going to be foods out there that we can afford?’
« ‘Is she going to be isolated? Are her friends at school not going to invite her to birthday parties because they’re scared that they’re going to give gluten to her?' »
She added: « Then you realise that people do want to help and they will help, and they do go out of the way to adjust things to keep her included.
« It’s okay to have your doubts on how your life’s going to change, but it isn’t as bad as what you might initially think. »
She explained: « There is support out there. There is the charity Coeliac UK that has loads of different information and advice available for parents – they’ve been our Bible. »
The NHS says coeliac disease is an auto-immune condition in which a person’s immune system attacks their own tissues when they eat gluten. It damages the small intestine so the body cannot properly take in nutrients.
Eating foods that contain gluten can trigger a range of gut symptoms, such as diarrhoea, stomach aches, sloating and flatulence, indigestion and constipation.
Coeliac disease can also cause more general symptoms, including:
Selina believes there needs to be greater awareness of the condition in children.
« We need to educate schools more, » she said. « We need to educate, you know, childcare provisions from nurseries to childminders to even children’s centres where these children go. »
It is a mission that she puts into practice in her own kitchen, with Eliza’s big brother, now aged 16, and younger sister – who was born after her diagnosis – being part of the family’s gluten-free lifestyle.
« We figured that there’s quite a few foods that are naturally gluten free. So we’ve got fruit, vegetables, rice, potatoes, so we do tend to make home-cooked meals so we know what’s safe for us all to eat, » Selina said.
It is a lifestyle her siblings have embraced.
Selina said: « Her brother knows a lot and is very protective over her so if Eliza is going to a friend’s house, for example, he’ll quiz her to make sure she understands what she can and can’t have. »
She added: « This is going to last her a lifetime and if it’s not well managed, she can have long lasting adverse effects from infertility to other diseases, such as higher risk of cancer. »
Eliza is more philosophical about her life, saying: « I’ve got a normal life, just like a normal person, just with a tiny, tiny little twist. »
And her advice to other children if they receive the same life-changing diagnosis is equally wise: « A friend would be scared that they’re not allowed to eat their favourite food and all, but they can always find better food. »
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