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Celiac Disease in Children: Causes, Symptoms and Treatment

​​​​​By Anna K. Trauernicht, M.D., Boys Town Pediatric Gastroenterology​​

Causes of Celiac Disease in Children

A child with celiac disease ​has a negative reaction to gluten, ​​a protein found in some grains, including wheat, rye, barley and triticale. Eating foods containing or contaminated by gluten causes the small intestine to become swollen, damaging the villi (finger-like projections that assist the body in absorbing nutrients).

Celiac Disease Symptoms

The symptoms of celiac disease vary greatly, making it difficult to diagnose. In fact, it is possible to have the condition without showing any symptoms at all (this is called silent celiac disease). Digestive symptoms are more commonly seen in kids than adults. Symptoms vary greatly between individuals and can include a combination or none of the symptoms below.

Common Celiac Symptoms in Infants

  • Chronic diarrhea
  • Swollen belly
  • Pain
  • Failure to thrive or weight loss

Common Celiac Symptoms in Children

  • Diarrhea
  • Constipation
  • Abdominal pain
  • Short stature, failure to grow
  • Delayed puberty
  • Attention-deficit/hyperactivity disorder (ADHD)
  • Learning disability
  • Lack of muscle coordination

Less common symptoms may include:

  • Iron-deficiency anemia
  • Blistering skin rash
  • Headache
  • Numbness in extremities
  • Fatigue

Again, symptoms vary greatly and come in no specific order or combination. If you suspect that your child has celiac disease, schedule an appointment with your pediatrician.

Testing for Celiac Disease

Do not change your child’s diet before your appointment, as this could change the results of celiac disease tests. You may want to have your child tested for celiac disease if the condition runs in your family or if you observe the following symptoms in your child:

  • Digestive discomfort or diarrhea lasting more than two weeks
  • Pale appearance
  • Irritability
  • Failure to grow or the development of a potbelly
  • Foul-smelling or bulky stools

Celiac Screening:

Blood tests are used to screen for celiac disease. You must be on a diet containing gluten prior to your blood screening for the test results to be accurate.

If a positive blood test is confirmed, your doctor will confirm the results of your screening with an endoscopy.

Treating Celiac Disease

Once diagnosed with celiac disease, patients must learn to maintain a gluten-free diet for the rest of their lives. Failure to do so may result in malnutrition, decreased bone density due to calcium loss, miscarriages or infertility, lactose intolerance and certain types of cancer. Your pediatrician may also prescribe vitamin supplements, steroids or skin medication.

Gluten-free foods are becoming increasingly common, but if you are concerned about maintaining a gluten-free diet for your child, ask your pediatrician ​about meeting with a dietician to discuss menu options, foods to eat when dining out and what to look for when grocery shopping.

 

Transcript

Celiac Disease

Anna Trauernicht, M.D.
​Pediatric GI

Celiac disease affects the small bowel and it makes it so the body doesn't absorb nutrients quite as well.

It can affect individuals from infancy to all the way through adulthood and it occurs in approximately one in 133 Americans. So, about one percent of the population has celiac disease.

The signs and symptoms can vary, quite significantly, from one person to the next. In some people you can have diarrhea and in others you can have constipation. You can have weight loss or weight gain. Often times you will have abdominal pain or belly pain and it's very hard to tell based on just symptoms alone.

How is celiac disease diagnosed?

The first way that we test for celiac disease is getting a blood sample. This can screen but the ultimate way we diagnose celiac disease is by doing an upper endoscopy, where we take samples of skin from inside the G.I. tract, to look for celiac disease.

For babies, they obviously can't tell us that they're having belly pain but we look for kids that have lots of spitting up or reflux. If they're having problems with growth or having difficulties with gaining weight, any of these things can give us a clue that we might need to screen for celiac disease.

How is celiac disease treated?

You have to avoid all items that contain gluten and gluten, unfortunately, is in many, many foods. That's why we have you work with our dietician so you can go through and find all of the hidden sources of gluten.

There aren't any medicines you need to use. If you make the change in your diet, you'll be able to treat the celiac disease.​​