Coeliac Disease In Children

Coeliac disease is a chronic autoimmune disorder that affects the small intestine. It is triggered by eating gluten (a protein found in wheat, barley and rye).

In children with coeliac disease, the immune system reacts to gluten and attacks the lining of the small intestine, causing inflammation and other symptoms.

Coeliac disease can occur at any age; while it is commonly diagnosed in childhood, it can also appear for the first time in adulthood. The symptoms and severity of coeliac disease can vary widely and some people may not develop symptoms until later in life.

It is a common misconception that children with coeliac disease will ‘grow out of it’ — coeliac disease is a lifelong condition with no known cure.

Coeliac disease can cause several symptoms which may range from mild to severe. It’s helpful to be aware of signs that your child may have coeliac disease.

Common digestive symptoms of coeliac disease in children include:

• Abdominal pain and discomfort
• A bloated tummy
• Flatulence
• Diarrhoea
• Constipation
• Vomiting

The damage to the small intestine caused by coeliac disease can affect the absorption of nutrients, which are essential for healthy growth and development. This can cause nutrient deficiencies, which can cause more general symptoms including:

• Difficulty gaining weight and growing at a normal rate
• Extreme tiredness, weakness and irritability (which may be a sign of iron or vitamin B12 deficiency — both of which are important for energy production)
• Dental problems, such as enamel defects, discolouration, pitting or ridges on the teeth

Some children with coeliac disease may develop a skin rash called dermatitis herpetiformis. This is characterised by itchy, blistering lesions on the skin. This rash is related to the immune response triggered by gluten ingestion and is a specific skin manifestation of coeliac disease.

It's important to note that not all children with coeliac disease will experience the same symptoms, and some may have no obvious symptoms at all.

Coeliac disease is an autoimmune condition, which means that the immune system mistakenly attacks healthy cells in the body. In the case of coeliac disease, the immune system reacts to gluten — leading to inflammation and damage to the lining of the small intestine.

Gluten is a protein found in wheat, barley and rye. It is commonly found in foods such as bread, pasta, cereals, cakes and biscuits.

It's worth mentioning that gluten can also be found in some non-food products, such as medications, supplements, hair and skin products, and even play dough.

The exact cause of coeliac disease is not fully understood, but it is believed to involve a combination of genetic and environmental factors.

Is coeliac disease genetic?

Coeliac disease often runs in families. If you have a close relative, such as a parent or sibling, with coeliac disease, your chances of developing the condition increase by around 10%.

Research shows that coeliac disease is strongly associated with mutations to certain genes. Children with these genetic abnormalities are more susceptible to developing coeliac disease. However, ​​these mutations are very common, suggesting that other factors can trigger the condition for some people.

Other risk factors for coeliac disease

Other health conditions may also be associated with an increased risk of coeliac disease. For example, type 1 diabetes, autoimmune thyroid disease (such as Hashimoto's thyroiditis or Graves' disease), and Down syndrome have been linked to a higher risk of coeliac disease.

If your child is experiencing symptoms of coeliac disease or if there is a family history of the condition, consider getting them tested.

Without proper management, coeliac disease can lead to complications, including malnutrition, growth problems, delayed puberty and chronic fatigue. The good news is that long-term complications can be prevented by getting your child diagnosed early.

Two main tests are commonly used for diagnosing coeliac disease: blood tests and small intestine biopsies.

Coeliac blood test

A blood test is the most common and easiest way to initially screen children for coeliac disease.

A coeliac blood test for children typically involves taking some blood, usually from the arm, to be sent to a laboratory for analysis. The blood test measures the levels of specific antibodies in the blood that are produced in response to gluten.

You will need to include gluten in your child’s diet when the test is carried out. If a gluten-free diet has already been started, it may affect the accuracy of the test results.

At Childhealthy, we offer a convenient and accessible blood testing service for children. The test can be booked online through our website, so you’ll be able to choose a time that suits you.

If your child's coeliac blood test results are positive and coeliac disease has been identified, paediatric dietitians can provide support and guidance on managing the condition through a gluten-free diet.

A gluten-free diet is the only treatment for coeliac disease. It involves avoiding all foods that contain gluten.

We can work with your child to create a personalised nutrition plan that eliminates gluten from their diet and provides tips on selecting safe and nutritious gluten-free foods. This may include incorporating alternative grains, such as rice, corn, quinoa and oats (that are labelled as gluten-free), as well as incorporating a variety of fruits, vegetables, protein sources and dairy or dairy alternatives into their diet.

In addition to a gluten-free diet, we may also discuss the need for any necessary supplements. Coeliac disease can affect the absorption of certain nutrients, such as iron, calcium and vitamin D, and supplementation may be needed to ensure your child's nutritional needs are met.