What to Know About Celiac Disease in Children

You may already know that, according to new research, celiac disease affects roughly 1 in every 100 people. However, you may not realize that many of those people are children.

As common as celiac disease is, there is still a great deal to learn about this condition. For example, it was once believed that celiac disease was simply a childhood illness that the child would eventually outgrow. What we know now, however, is that this condition affects men and women of all ages.

Not only does celiac disease affect people of all ages, races, and backgrounds, but it is a lifelong condition that cannot simply be “outgrown”. Switching to a gluten free diet is the only treatment available but, unfortunately, many people go through years of misdiagnosis.

Celiac disease can be particularly difficult to diagnose in children because the symptoms are often different than they are in adults. Keep reading to learn more about celiac disease in children.

Celiac disease is an autoimmune disease triggered by the consumption of gluten. When someone with the disease eats gluten, their immune system responds to it like it would a foreign invader and, in the process of destroying the gluten, it accidentally destroys healthy gut tissue.

Because celiac disease causes progressive damage to the small intestine, many people who go undiagnosed for any length of time develop malnutrition and/or nutritional deficiencies. As you can imagine, the consequences of such can be extremely dangerous for children. But what does celiac disease look like in children compared to adults?

Celiac disease symptoms look different in children depending on their age. If a child has developed celiac disease at birth, symptoms will usually be present after gluten-containing foods are regularly introduced into the child’s diet.

Here are some of the most common symptoms of celiac disease in infants and toddlers:

• Vomiting
• Irritability
• Bloating
• Poor growth
• Distended abdomen
• Diarrhea
• Very foul-smelling stools
• Malnutrition

When a school-age child develops celiac disease, the symptoms are less likely to include vomiting but may still include other types of digestive distress. Here are some common symptoms of celiac disease in school-age children:

• Distended abdomen
• Diarrhea
• Constipation
• Stomach aches
• Abdominal pain
• Difficulty gaining or losing weight

As school-age children become teenagers and young adults, they will develop symptoms that are not closely related to the gastrointestinal tract – these are called “atypical” or “extra-intestinal” symptoms. Here are a few examples:

• Unexplained weight loss
• Stunted growth
• Delayed onset of puberty
• Painful bones or joints
• Chronic fatigue
• Recurrent headaches and migraines
• Dermatitis herpetiformis (itchy skin rash)
• Recurring mouth sores (aphthous ulcers)

There are some cases in which children have only mild symptoms or no symptoms at all. These cases can be particularly difficult to diagnose.

Remember, celiac disease looks different in every patient and symptoms can develop at any age. For adults, chronic fatigue is one of the most common symptoms, but many children exhibit irritability. Only about 20% to 30% of children with celiac disease have stomach-related symptoms.

If you suspect that your child may have celiac disease, don’t delay in talking to your pediatrician to get a blood test. Keep in mind that you’ll have to keep your child on a gluten-containing diet in order for the results to be accurate – your child may also require additional testing if the results are positive.

If you notice that your child is exhibiting some of the symptoms listed above, you would be right to be concerned about the possibility of celiac disease. Because celiac disease is often confused for other conditions, however, you may want to delve a little deeper before bringing your pediatrician in.

In addition to reviewing your child’s symptoms, take a moment to consider common risk factors for celiac disease to see if they line up. Here are some of the common risk factors for celiac disease:

• Family history (children having a first-degree relative with celiac disease have a 1 in 10 risk of developing it).
• Having either the HLA-DQ2 or HLA-DQ8 gene.
• Having another autoimmune disease, such as hypothyroidism or type 1 diabetes.
• Having a genetic disorder like Turner syndrome or Down syndrome.
• High liver enzyme levels (including enzymes like AST and ALT).

If your child tests positive for celiac disease, you’re going to need to switch him to a gluten free diet as soon as possible. Every day your child continues to consume gluten is another day’s worth of damage to his intestines. But what exactly are the complications associated with untreated celiac disease?

Continuing to feed your child gluten-containing foods means that his small intestine is still being damaged and that could lead to nutrient deficiencies, malnutrition, and stunted growth. These problems can then develop into more serious issues like anemia or bone loss. As an adult, your child could then go on to develop osteoporosis, infertility, and even certain types of cancer.

As difficult as it can be to make the switch to a gluten free diet, it is the only effective treatment option and well within your child’s best interests.

Being diagnosed with celiac disease is never easy because treatment requires a complete overhaul of your diet. However, it is even more complicated because a child may not be old enough to understand his or her condition or why they have to change what they eat.

When your child is at home, you can control what he/she eats. You’ll be able to prepare healthy and gluten free meals, so your child doesn’t feel deprived. When he/she is at school, however, it might not be so easy. Your child may not understand the dangers of accidentally eating gluten, so you’ll have to rely on his teachers and any other school staff to keep him safe.

Here are some tips for keeping your child safe at school:

• Always pack your child’s lunch and make sure to switch things up, so he/she doesn’t get bored and be tempted by something unsafe.
• Have your child help you prepare his meals and snacks, so he/she feels involved in the process and is more excited to eat them.
• Have a talk with your child’s teacher as well as the principle and other school staff before the school year starts to make sure they understand his dietary restrictions.
• Teach your child to ask if food is gluten free before eating it – even if he/she isn’t old enough to understand exactly what gluten is, it’s a good safety measure to have in place.
• If your child is old enough, teach him to read food labels and to identify sources of gluten (including hidden sources of gluten).
• Type up a note explaining your child’s condition as well as his dietary needs and put copies in his backpack and give them to his teacher and any other staff he’ll be interacting with.

Making a change to your child’s diet is always going to be difficult, no matter what the reason. If your child is already a picky eater, things are probably going to get a lot worse before they get better. You’ll need to be patient and keep a cool head, reminding yourself even as your child is throwing a tantrum in the middle of the kitchen that you’re doing what is best for him.

If you’re struggling to make the transition with your child, ask your pediatrician about support groups – even the simple act of talking to someone else who is going through the same thing as you can be helpful. There are also plenty of online resources available from various Celiac Disease organizations like the Celiac Disease Foundation.

Having a child diagnosed with celiac disease can be a shock, and it will definitely take some time to learn how to handle it. Just keep in mind that you’re doing it for your child’s health and wellness because that’s all that really matters.