How to tell if your child has celiac disease

Celiac Disease (for Parents) - Nemours KidsHealth

What Is Celiac Disease?

Celiac disease is an autoimmune disorder. It happens when someone has a food intolerance to gluten. Gluten (GLOOT-in) is the general name of proteins found in wheat, rye, barley, and other grains.

In celiac (SEE-lee-ak) disease, the body can’t absorb important nutrients. If that happens, a person can become malnourished.

Doctors don't know for sure why the immune system reacts to gluten. But if your child has celiac disease, there are ways to manage symptoms and prevent damage to the intestines.

What Are the Signs & Symptoms of Celiac Disease?

Celiac disease — also known as celiac sprue, gluten-sensitive enteropathy, and non-tropical sprue — can cause a wide variety of symptoms. Infants may not gain weight and length as expected, a condition called failure to thrive. Older kids can have:

diarrhea
constipation
pale, foul-smelling stools (poop)
belly pain and bloating
weight loss
tiredness
headaches
painful skin rashes (usually in older teens and adults), especially around the elbows and knees

Some people don’t have any symptoms.

Symptoms can happen at any time in a child's life. Some kids have problems the first time they have gluten, but others get symptoms years after safely consuming gluten products.

A baby might show the first signs of celiac disease soon after starting solid foods such as cereal. Signs might include diarrhea, stomach pain, and not gaining weight at a healthy pace.

Over time, a child might not reach the expected height, may develop anemia and mouth sores, and can have behavior issues.

What Causes Celiac Disease?

In celiac disease, gluten triggers the immune system to damage villi. Villi (VIL-eye) are finger-like projections lining the small intestine that absorb nutrients from food and send them into the bloodstream. Damaged villi can't absorb the vitamins and minerals that a child needs to grow.

The cause of celiac disease isn’t known. It tends to run in families, so a child with a family history of the condition may be more likely to get it. It also can happen along with other disorders, such as Down syndrome, Williams syndrome, type 1 diabetes, and autoimmune thyroid disorders.

How Is Celiac Disease Diagnosed?

Diagnosing celiac disease usually starts with a blood test to look for antibodies to gluten and other proteins in the intestine’s lining. Antibodies are proteins the immune system makes that recognize and get rid of germs and other things it sees as threats. They usually stay in our bodies in case we have to fight that germ or problem again. If the blood test finds high levels of antibodies to gluten, the doctor probably will do a biopsy of the small intestine to send for testing.

To do a biopsy, doctors put a long, thin tube (called an endoscope) through the mouth and stomach into the small intestine to get a small tissue sample. A child usually is sedated or under general anesthesia to sleep through the procedure.

If a child is diagnosed with celiac disease, their siblings, parents, and grandparents should get tested too. They could have the disease but no symptoms. Celiac disease that isn’t found in adults for a long time can lead to serious health problems.

How Is Celiac Disease Treated?

There is no cure for celiac disease. Researchers are working on new treatments, and many show promise. But for now, the condition is managed with a gluten-free diet. This lets the intestinal lining heal, and helps ease symptoms.

Dietary Changes

If your child has celiac disease, the doctor will guide you on which foods your child can eat and which to avoid. These changes will have a big impact on your family's everyday life and your child's diet. So the doctor may suggest that you meet with a dietitian for advice.

Your child’s diet should have no wheat, barley, rye, and related grains. No law requires food manufacturers to list gluten on food labels, so making sure your child avoids it can be hard. In the United States, all foods must be clearly labeled if they contain any of the top eight food allergens, including wheat. But wheat-free doesn’t mean gluten-free — some wheat-free products may have gluten-containing grains like barley and rye in them.

Carefully read food labels on all items before you buy them or let your child have them. And help your child learn to do it too. The Celiac Disease Foundation’s website lists many foods and drinks to watch out for.

Finding Safe Options

Here are some tips to remember when choosing foods:

Start with the foods your child can eat. Safe foods and ingredients include foods made with the flours of corn, rice, buckwheat, sorghum, arrowroot, garbanzo beans (chickpeas), quinoa, tapioca, teff, and potato. Also OK are all plain meats, fish, chicken, legumes, nuts, seeds, oils, milk, cheese, eggs, fruits, and vegetables.
Watch for cross-contamination. Sometimes, gluten-free foods can come into contact with foods that contain gluten (called cross-contamination). For example, crumbs from regular wheat bread can find their way into jams, spreads, or condiments if people aren't careful to use a fresh knife or utensil each time. Keeping condiments in squeezable bottles and using separate butter, jams, and spreads for people with celiac disease is a great idea. You might also keep a separate toaster for gluten-free bread.
Clean appliances, utensils, and work surfaces before you make gluten-free products, especially after handling foods that contain gluten. Wash your hands well and often when you prepare food.
In restaurants: Tell the server or the kitchen staff about your child's condition so they know that your child's food must be free of gluten and related ingredients.
In grocery stores: Most carry some gluten-free bread, cereal, baking mixes, cookies, crackers and other products. Health food stores and natural food markets may have wider selections of these foods. Skip gluten-free products from bulk food bins because of the risk of cross-contamination.

What if My Child Does Get Something With Gluten?

Even with these precautions, your child may ingest gluten at some point. That's OK — a single small exposure may cause mild inflammation in the gut, but probably won't lead to immediate symptoms. Normally, the lining of small intestine completely renews itself every 3–4 days. So after a single incident, new cells quickly replace damaged ones. Repeated exposure to gluten, though, will lead to ongoing damage of the intestinal lining.

How Can Parents Help?

If your child has celiac disease, tell the other adults in your child's life — caregivers, teachers, school nurses, camp counselors, babysitters, and friends' parents — and explain the importance of keeping foods with gluten away from your child. Teach older kids not to accept foods from others unless they're from someone who can ensure the food is gluten-free.

Help your child adapt to a gluten-free diet. This can be a challenge, especially at first. But over time, you and your child will get to know which foods are OK and which are not, making it easier to find safe meals, snacks, and ingredients.

Reassure your child that they’re not alone with these dietary problems. Your doctor might be able to recommend a local support group. Online support groups and organizations can help too, such as:

Celiac Disease Foundation
Beyond Celiac
National Celiac Association

Reviewed by: Jolanda M. Denham, MD

Date reviewed: January 2021

Celiac Disease (for Kids) - Nemours KidsHealth

Have you ever eaten gluten? If you've ever eaten a piece of bread, a slice of pizza, or a bowl of cereal, chances are you have.

What's Gluten?

Gluten (say: GLOO-tin) is a protein found in wheat, rye, and barley — grains that are in many everyday foods. Most of us eat food with gluten with no trouble. But for some people, eating gluten can cause a reaction in their bodies. Someone who has this problem has celiac (say: SEE-lee-ak) disease.

After you eat food, it goes to your stomach, which is part of a group of organs that make up your digestive system. An important part of the digestive system is the small intestine, which is lined with villi (say: VIL-eye).

Villi are usually described as microscopic, finger-like projections. They're extremely small — so small you can't see them without a microscope. The villi are important because they absorb nutrients into the body.

For someone with celiac disease, eating gluten — in a piece of bread, for instance — causes an immune system reaction. Your immune system ordinarily keeps you from getting sick, but in someone with celiac disease, the body starts damaging and destroying the villi. Without villi, the body can't absorb vitamins and nutrients from food. Without enough nutrients, a kid's body has a tough time staying healthy and growing properly. Even if the person eats a lot, they still might lose weight and could develop anemia (say: uh-NEE-me-uh) from not absorbing enough iron.

Why Do Kids Get Celiac Disease?

No one is sure why celiac disease happens, but it appears to run in families. Many people who have celiac disease do not know it. If all these people were diagnosed, celiac disease would be more common than type 1 diabetes.

What Are the Signs & Symptoms of Celiac Disease?

Common symptoms of celiac disease are diarrhea, decreased appetite, stomachache and bloating, poor growth, and weight loss. Many kids are diagnosed with it when they're between 6 months and 2 years old, which is when most kids get their first taste of gluten in foods.

For some people, the problems start slowly and the symptoms may be terrible one week and not as bad the next. Because of this, some people aren't diagnosed with celiac disease until they're older. The problem is chronic, which means that although symptoms may come and go, people who have celiac disease will always have it.

Someone with celiac disease may feel tired and could be irritable. Some also have skin rashes and mouth sores. The problem is sometimes mistaken for other digestive problems called inflammatory bowel disease (IBD) or lactose intolerance. And in some cases, a kid won't have any symptoms and then will all of a sudden start having problems during a time of stress, such as after an injury.

How Do People Know They Have It?

Someone who has a lot of stomachaches, diarrhea, weight loss, or any of other symptoms of celiac disease should talk to a doctor. It may or may not be celiac disease, but a doctor can help sort this out and will usually order a screening blood test.

If the screening tests show a person might have celiac disease, the next stop usually is to see a gastroenterologist, a doctor who treats digestive problems. This specialist may decide to take a sample of the small intestine to look at under the microscope. This small sample is called a biopsy. If a biopsy is done, the doctor will give some special medicine to help the person stay comfortable during the procedure.

How Is Celiac Disease Treated?

Celiac disease is treated by not eating gluten. This can be hard because gluten is in many foods, but a dietitian can help adjust someone's diet to cut out gluten. It is important not to start a gluten-free diet unless you are truly diagnosed with celiac disease.

Following a gluten-free diet allows the small intestine to heal. But that doesn't mean the person can start eating gluten again. For someone with celiac disease, gluten will always irritate the intestines and, if this happens, the diarrhea, belly pain, and other problems will return.

If you're diagnosed with celiac disease, it can be a challenge to learn which foods contain gluten. You may not be able to remember them all, but you can keep a list with you and ask about menu items at restaurants before digging in. Before you know it, you'll be a pro at knowing which foods are safe and which are not.

Gluten-Free Foods

Here's a quick quiz: Which of these foods contain gluten?

pizza
fried chicken
pasta

If you said all three, you're right! Pizza was the easiest choice because you know the crust is bread. But did you know that battered foods like fried chicken and even some French fries contain gluten? Pasta also contains gluten because it is made from wheat. Luckily, you can make or buy gluten-free pizza crust, make fried chicken with a gluten-free batter, and find gluten-free pasta. In fact, nearly all of the foods we eat can be made gluten free.

Besides foods that contain gluten, you'll need to watch out for foods that may have been contaminated with gluten. This is called "cross-contamination." It means a food doesn't contain gluten as an ingredient but came into contact with gluten-containing foods. This is most likely to happen at home in your own kitchen — for instance, wheat bread crumbs in the toaster, the butter, or jar of peanut butter.

If you have celiac disease you will need your own toaster and you should also have separate spreads and condiments to avoid cross-contamination. Some foods are contaminated during processing, so your mom or dad can help you by finding certified gluten-free foods. For instance, gluten-free oats are now available for people with celiac disease.

The best approach is to read labels. Food labels must say if they're wheat-free products. But a "wheat-free" food isn't necessarily a "gluten-free" one because wheat-free products may have barley and rye (gluten-containing grains) in them.

What Else Should I Know?

Getting used to a gluten-free diet can be hard at first. But over time, you will get to know which foods are OK and which are not, making it easier to find safe meals, snacks, and ingredients.

Remember that you’re not alone with these dietary problems. This website for kids can help too:

Beyond Celiac

Reviewed by: Jolanda M. Denham, MD

Date reviewed: January 2021

Celiac disease in children: tips and facts

Celiac disease is a serious autoimmune disease that affects about 1 in 100 people. A person can develop celiac disease at any age, including childhood. The symptoms of celiac disease can vary widely and most often go undiagnosed, leading to even more serious long-term health problems. Celiac disease is especially difficult to identify in children, as most do not experience digestive symptoms after eating gluten. It is important to diagnose celiac disease as early as possible to prevent serious damage to the child's intestines. nine0003

Find out everything you need to know about celiac disease in children, from symptoms and signs to causes, treatment, and possible consequences of not being treated.

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What is celiac disease in children?

It used to be that celiac disease was a condition that children could outgrow. But unlike allergies, this is for life. Celiac disease is an autoimmune disease caused by eating gluten, not a gluten allergy. In a person with celiac disease, the immune system mistakenly identifies gluten as an uninvited invader and releases antibodies that attack it. These antibodies also damage the lining of the small intestine, preventing the absorption of important nutrients. nine0003

If a child's celiac disease is left untreated, height, weight, physical development, and general health may be affected because damaged intestinal lining cannot absorb nutrients properly. Left untreated for celiac disease, it can even lead to malnutrition.

What causes celiac disease in children?

Celiac disease occurs in people who have a genetic predisposition but are caused by environmental factors that people have not yet fully understood. People ask if celiac disease can run in families, and the answer is yes, partly. Celiac disease can affect entire families, but it doesn't run like a normal hereditary disease. nine0003

HLA antigens help the immune system to distinguish between proteins that belong to our body and those produced by external pathogens such as viruses and bacteria. Approximately 99% of people with celiac disease have one of the following HLA antigen variants: HLA DQ2.5, HLA DQ8, or HLA DQ2.2. Approximately 30% of the population has genes that put them at risk, but only 3% develop celiac disease.

If a child's next of kin has celiac disease, there is about a 10% chance that they will develop celiac disease after adding gluten to their diet. If your child is genetically predisposed, you should watch for the first signs of celiac disease. Unfortunately, it is impossible to keep the child from this disease, but research is ongoing. may reduce the risk of celiac disease. nine0003

Several studies suggest that the best time to introduce gluten into a baby's diet is between four and six months of age, preferably in conjunction with breastfeeding. However, there is no data on the exact amount of gluten that can be introduced into a baby's diet during this period ..

Signs and symptoms

How do I know if my child has celiac disease? The list of signs and symptoms of celiac disease should be treated with caution, as everyone is different. Some children may have classic symptoms, while others may have unusual symptoms. Common symptoms in toddlers include stomach and abdominal pain, bloating, diarrhea, constipation, trouble gaining weight, or even weight loss. nine0003

Older children and adolescents are more likely to have other symptoms. A child with celiac disease may not have any obvious digestive problems, but may not develop physically well compared to their peers. He may be smaller and/or not feel the physical changes associated with puberty. Symptoms may include stunting, weight loss, delayed puberty, bone and joint pain, chronic fatigue, migraines, itchy skin rash (dermatitis herpetiformis) and regular mouth ulcers. nine0003

It is worth noting that the majority of children in developed countries diagnosed with celiac disease were not underweight.

In addition, adolescents with celiac disease may experience mood disorders, including anxiety, depression, and panic attacks.

If you notice any of these signs or symptoms in your child, we recommend that you contact your doctor or pediatrician. Telling him about celiac disease or other autoimmune diseases in other family members will help in making a diagnosis. Diagnosing celiac disease is like usually a two-step process involving a blood test and taking a biopsy from the small intestine. nine0003

It is important not to exclude gluten from a child's diet before testing for celiac disease, as the results will not show anything if the body does not react to gluten daily.

Treatment

The only treatment for celiac disease is a strict gluten-free diet. In a few weeks or months after switching to a gluten-free diet, the child will feel much better and the symptoms will begin to disappear. On a gluten-free diet, a child can grow and develop completely normally. nine0003

Side Effects of Celiac Disease in Children

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Without treatment for celiac disease, a child may experience various consequences, which we mentioned when discussing common signs and symptoms. In addition to these symptoms, there may also be other consequences that may be difficult to determine. For example, babies with celiac disease can develop increased irritability that is difficult to notice in isolation from the child's temperament and emotions. In addition, children with celiac disease are often picky eaters, which may be due to the discomfort they feel after eating food containing gluten. . nine0003

Tips for coping with celiac disease in children

Given that there is no cure for celiac disease and a strict gluten-free diet is the only treatment, it can be difficult for children to manage the condition. It is important that the child understands the situation and is able to overcome the difficulties that arise. The more and more clearly you talk about it, the easier it will be for the child to explain to others what celiac disease is, and the easier it will be for him to cope with it.

Here are some ideas for helping your child cope with celiac disease:

Talk to school staff or other staff who will be preparing or overseeing the preparation of your child's meals so that the menu is adapted for him and that foreign products are not included in his meals;
make sure teachers and carers understand what celiac disease is and don't worry about it - it's not an allergy with the possibility of anaphylactic shock, so they just need to make sure that the child does not eat what he should not; nine0003
Find out if your child's art class will use pasta or other gluten-containing products and prepare a gluten-free alternative;
think about what else your child might put in their mouth besides food. For example, some types of plasticine also contain gluten;
plan for your child a delicious gluten-free snack or sweets that he can eat when other children eat their sweets; nine0003

furthermore, arrange for something tasty and gluten-free at the party that all children can eat;
Make sure your child always has gluten-free food available when they don't have alternatives to gluten-containing meals.

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Does your child suffer from celiac disease?

Early diagnosis of celiac disease is very important for your child's health, growth and development and of course dealing with the symptoms of the disease.

If you suspect that your child has celiac disease, it is very important to be examined by a pediatrician and gastroenterologist.

If your child has been found to be suffering from celiac disease, it is important to know that he needs constant supervision, including by a pediatric clinical nutritionist. nine0003
What is celiac disease?

Celiac disease is a common autoimmune disease caused by an immune diet reaction to gluten, a protein found in barley and rye flour common in European and Israeli diets. The disease can present at any age, including infants who refuse to breastfeed after gluten is introduced into the diet, as well as in children and adolescents. In children with celiac disease who continue to consume gluten, the immune system can damage the lining of the small intestine. nine0003
Celiac disease is the most common nutritional chronic childhood disease in Europe and Israel.
About 80% of cases remain undiagnosed.
Celiac disease is one of the most popular childhood chronic diseases, affecting 1 in 100 children.

Although it is usually very easy to diagnose celiac disease, in some cases an accurate diagnosis can be delayed up to 8 years.

Early diagnosis prevents complications.

In recent years, celiac disease has become more and more popular. nine0003
Is the child diagnosed? Check yourself too:

Today, if there is a suspicion of celiac disease in a child, first of all they diagnose him, and after that all other family members. Very often it turns out that the parents are also sick, but simply did not know about it.

Celiac disease - how does the disease manifest itself?

The disease can present at any age, from infancy to adolescence.

Statistics

Celiac disease occurs in one in 100 children in most European countries and in Israel. In some countries, the ratio between sick and healthy children is as high as 3:100, but most children are not diagnosed.

Complications due to misdiagnosis

If not diagnosed early, celiac disease can cause serious complications: weight loss, growth failure, late puberty, anemia and iron deficiency, chronic fatigue, osteoporosis, and the risk of other autoimmune diseases. nine0003
What are the most common symptoms of celiac disease?

Diarrhea, abdominal pain, weight loss, chronic fatigue, growth failure, late puberty, anemia, oral aphthae, increased liver enzyme levels, nausea, vomiting.

Thanks to the European/Israeli plan for the early diagnosis of celiac disease, it is possible to diagnose and treat the disease, while at the same time reducing the risk of additional problems, complications and developmental problems.
1. Increased public acceptance of celiac disease
2. Increased acceptance of the disease by the medical community and the health care system, knowledge of symptoms and risk groups.
3. Establishment of a nationwide program for the early diagnosis of celiac disease in children
Diagnosis and treatment at the Kaplan Medical Center

A large number of children are diagnosed at the Pediatric Gastroenterology Clinic in Kaplan, from 7 to 10 are diagnosed here every month children. nine0003
In addition, more than 440 children diagnosed with celiac disease have been treated by Kaplan in recent years.

Academic Research

The Kaplan Medical Center is conducting extensive research initiated by Dr.
Learn more