Coeliac disease symptoms in children
Coeliac disease may develop any time after wheat or other gluten containing foods are introduced into the diet, typically after 6-9 months of age. It is unknown why some children become ill early in life and others fall ill only after years of exposure. There is wide variation in the severity of symptoms – many children will experience symptoms within minutes to hours after consuming gluten, which may only last a few hours. In others, symptoms may last several days, or up to two weeks. Many children have mild symptoms that are easy to miss, such as having excessive gas, abdominal pain, or constipation. Other children have more severe symptoms that can result in an earlier diagnosis, including failure to thrive, weight loss, and vomiting. Fortunately, children and adolescents typically respond well to treatment with the gluten free diet. Most children feel significantly better after two weeks on the diet and attain normal height, weight, and bone health.
Infants and Toddlers
Infants and toddlers tend to have more obvious symptoms which usually manifest in the gastrointestinal tract. Symptoms include, but are not limited to:
Infants and toddlers can suffer from malnutrition, leading to poor growth in weight and/or height.
Screening for Coeliac Disease in Children Under the Age of 3
From the University of Chicago Coeliac Disease Center: “Generally, children at risk for coeliac disease are screened at age 2 or 3 unless symptoms are seen beforehand. In children younger than 3, with symptoms, antibody testing may not always be accurate. Children must be eating wheat or barley-based cereals for some time, up to one year, before they can generate an autoimmune response to gluten that shows up in testing. A pediatric gastroenterologist should evaluate young children experiencing a failure to thrive or persistent diarrhea for coeliac disease. While a genetic test cannot diagnose coeliac disease by itself, it can all but rule it out if neither of the genes are present, and a genetic test can be done at any age.”
Vomiting is less common in school-age children than in infants and toddlers. Symptoms include, but are not limited to:
Older Children and Teens
Older children and teenagers may have symptoms or concerning signs that are not obviously related to the intestinal tract, which are called “extra intestinal” or “atypical” symptoms. These symptoms are what may convince a physician to test for celiac disease. Some of these manifestations include:
Adolescents with coeliac disease may also have mood disorders, including anxiety and depression, as well as panic attacks.
Coeliac Disease in Children with No or Mild Symptoms
There are two primary ways that coeliac disease can be found in children without symptoms of concern. The first is to have an associated condition in which testing for coeliac disease is recommended:
The second is to have other signs of celiac disease that do not cause typical symptoms:
Severe Coeliac Disease in Children
Severe cases of coeliac disease in childhood are now very rare. Symptoms of severe cases include:
Family Members and Risk
It is very important to test your child for coeliac disease at the very first signs, or if coeliac disease runs in your family. First-degree relatives (parent, sibling, child) of someone with coeliac disease have a 1 in 10 chance of developing coeliac disease themselves.
A simple blood test is available to screen for coeliac disease. People with coeliac disease who eat gluten have higher than normal levels of certain antibodies in their blood. These antibodies are produced by the immune system because it views gluten (the proteins found in wheat, rye and barley) as a threat. You must be on a gluten-containing diet for antibody (blood) testing to be accurate.
The only way to confirm a coeliac disease diagnosis is by undergoing an endoscopic biopsy of the small intestine.
Some people experience symptoms found in coeliac disease, such as “foggy mind”, depression, ADHD-like behavior, abdominal pain, bloating, diarrhea, constipation, headaches, bone or joint pain, and chronic fatigue when they have gluten in their diet, yet do not test positive for coeliac disease. The terms non-coeliac gluten sensitivity (NCGS) and non-coeliac wheat sensitivity (NCWS) are generally used to refer to this condition, when removing gluten from the diet resolves symptoms.
Currently, the only treatment for coeliac disease and non-coeliac wheat sensitivity is lifelong adherence to a strict gluten-free diet. People living gluten-free must avoid foods with wheat, rye and barley, such as bread and beer. Ingesting small amounts of gluten, like crumbs from a cutting board or toaster, can trigger intestinal damage.
Once diagnosed, annual follow-up with your physician is necessary to monitor nutritional deficiencies and your compliance with a gluten-free diet, as well as assess for associated conditions.
Coeliac Disease Foundation can help you find the right doctor to discuss symptoms, diagnose, and treat coeliac disease. Our nationwide Healthcare Practitioner Directory lists primary care physicians and specialists,and dietitians and mental health professionals, experienced in coeliac disease and non-coeliac wheat sensitivity.