Celiac disease is caused by an intolerance to the protein gluten, which is found in foods that contain wheat, rye and barley.
Although once thought to be rare, celiac disease is now known to be fairly common, affecting up to 1% of people in the United States.
Unfortunately, celiac disease still isn't as well known as many other pediatric conditions, and many parents and pediatricians may overlook the symptoms.
Children can develop symptoms of celiac disease once gluten has been introduced in to their diet — usually sometime between 6 months and 2 years of age. Infants are often first introduced to gluten when they "graduate" from rice cereal and start a single grain cereal with barley or Cheerios, etc.
Celiac Disease Symptoms
Symptoms of celiac disease can include:
- delayed growth and failure to thrive
- chronic diarrhea
- behavioral changes, including irritability
- vomiting
- poor appetite
- recurrent gas, abdominal bloating and abdominal pain
- pale or foul-smelling or fatty stools
- constipation
- fatigue
- unexplained iron deficiency anemia (a low red blood cell count)
- delayed puberty
- a skin rash (dermatitis herpetiformis) that causes itchy blisters to form on a child's elbows, knees and buttocks.
These symptoms do vary, though. Some children with celiac disease have no symptoms at all, while other children with celiac disease may be clingy, irritable and hard to console.
Celiac Disease Tests
Although some people simply try and see if their child will improve on a gluten-free diet, since this is a lifelong condition, formal diagnosis and testing is usually a good idea.
Testing for celiac disease can include screening blood tests, such as:
- Immunoglobulin A (IgA)
- antitissue transglutaminase (tTGA)
- IgA anti-endomysium antibodies (AEA)
If these screening tests show signs of celiac disease, a small bowel biopsy will usually be done by a pediatric gastroenterologist to confirm the diagnosis.
What You Need to Know
- There is no cure or medication to treat celiac disease. Instead, parents must put their children on a gluten-free diet that doesn't contain any foods that are made with wheat, rye or barley.
- Many experts also recommend that a child on a gluten-free diet also avoid oats.
- In addition to many foods, gluten can also be found in some candy, cold cuts, soy sauce, vitamins, herbal supplements, over-the-counter medications and prescription medications.
- To help avoid gluten, including many grains, pasta, cereals and other processed foods with gluten, it can help to learn to read food labels.
- A pediatric gastroenterologist can help diagnose and treat your child with celiac disease.
Sources:
Trends in the presentation of celiac disease. Rampertab SD - Am J Med - 01-APR-2006; 119(4): 355.
Behrman: Nelson Textbook of Pediatrics, 18th ed.