Does my child suffer from coeliac disease? Here are the telltale symptoms
Coeliac disease is an autoimmune disease involving a rather well-known and widespread food intolerance related to gluten
Gluten (GLOOT-in) is the generic name for proteins found in wheat, rye, barley and other cereals.
In coeliac disease (SEE-lee-ak), the body cannot absorb important gluten-related nutrients and this leads to problems with the body’s proper nutrition.
What are the signs and symptoms of coeliac disease?
Coeliac disease, also known as 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 growth retardation.
Older children may manifest
- diarrhoea
- constipation
- pale, foul-smelling stools (poo)
- tummy ache and bloating
- weight loss
- tiredness
- headaches
- painful rashes (usually in older adolescents and adults), especially around the elbows and knees
Some people have no symptoms at all.
Symptoms can occur at any time in a child’s life.
Some children have problems the first time they have gluten, but others show symptoms years after they have safely consumed gluten products.
A child may show the first signs of coeliac disease soon after starting to eat solid foods such as cereals
Signs might include diarrhoea, stomach pain and failure to gain weight at a regular rate.
Over time, a child may not reach the expected height, develop anaemia and mouth sores and have behavioural problems.
What are the causes of coeliac disease?
In coeliac disease, gluten activates the immune system to damage the 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 cannot absorb the vitamins and minerals a child needs to grow.
The cause of coeliac disease is unknown
It tends to follow a genetic and familial transmission, but may also be associated with other disorders or conditions, such as Down syndrome, Williams syndrome, type 1 diabetes and autoimmune thyroid disorders.
How is coeliac disease diagnosed?
The diagnosis of coeliac disease usually starts with a blood test to look for antibodies against gluten and other proteins in the lining of the intestine.
Antibodies are proteins produced by the immune system that recognise and get rid of germs and other things it sees as threats.
They usually remain in our bodies in case we have to fight that germ or problem again.
If the blood test detects high levels of antibodies against gluten, the doctor will probably perform a biopsy of the small intestine to be sent for testing.
To perform a biopsy, doctors insert a long, thin tube (called an endoscope) through the mouth and stomach into the small intestine to take a small sample of tissue.
A child is usually sedated or under general anaesthesia to sleep during the procedure.
If a child is diagnosed with coeliac disease, their siblings, parents and grandparents should also be tested. They may have the disease but no symptoms.
Coeliac disease that has not been found in adults for a long time can lead to serious health problems.
How is coeliac disease treated?
There is no cure for coeliac disease.
Researchers are working on new treatments and many are showing promise.
But for now, the condition is managed with a gluten-free diet.
This allows the intestinal lining to heal and helps relieve symptoms.
Dietary changes
If your child has coeliac disease, your 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 daily life and your child’s diet.
Therefore the doctor may suggest that you meet with a dietician for advice.
Your child’s diet should not contain wheat, barley, rye and related cereals.
No law requires food manufacturers to list gluten on food labels, so making sure your child avoids it can be difficult.
Read the food labels on all items carefully before you buy them or let your child have them.
And help your child learn to do so, too.
Here are some tips to remember when choosing foods:
- Start with foods your child can eat. Safe foods and ingredients include foods made from maize flour, rice, buckwheat, sorghum, arrowroot, chickpeas (garbanzo beans), quinoa, tapioca, teff and potatoes. Also OK are all simple meats, fish, chicken, legumes, nuts, seeds, oils, milk, cheese, eggs, fruit and vegetables.
- Watch out for cross-contamination. Sometimes, gluten-free foods can come into contact with foods that contain gluten (called cross-contamination). For example, crumbs from normal wheat bread can find their way into jams, spreads or condiments if people are not careful to use a new knife or utensil each time. Keeping condiments in squeezable bottles and using separate butter, jams and spreads for people with coeliac disease is a good idea. You could also keep a separate toaster for gluten-free bread.
- Clean appliances, utensils and work surfaces before making gluten-free products, especially after handling food containing gluten. Wash your hands well and often when preparing food.
- In restaurants: inform the waiter or kitchen staff of your child’s condition so that they know that your child’s food must be free of gluten and related ingredients.
- In grocery shops: most sell bread, cereals, cake mixes, biscuits, crackers and other gluten-free products. Health food shops and health food markets may have wider selections of these foods. Skip gluten-free products from bulk food containers because of the risk of cross-contamination.
What happens if my child receives something with gluten?
Even with these precautions, your child may ingest gluten at some point.
That’s OK: a single small exposure may cause a slight inflammation in the intestine, but it probably won’t lead to immediate symptoms.
Normally, the lining of the small intestine completely renews itself every 3-4 days.
Therefore, after a single incident, new cells quickly replace the damaged ones.
Repeated exposure to gluten, however, will lead to continuous damage of the intestinal lining.
How can parents help?
If your child has coeliac disease, tell the other adults in your child’s life – carers, teachers, school nurses, camp counsellors, babysitters and parents of friends – and explain the importance of keeping foods with gluten away from your child.
Teach older children not to accept food from others unless it comes from someone who can guarantee that the food is gluten-free.
Help your child adjust to a gluten-free diet.
This can be a challenge, especially in the beginning.
But over time, you and your child will learn which foods are OK and which are not, making it easier to find safe meals, snacks and ingredients.
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