Understanding Coeliac Disease In Children​

What is Coeliac Disease?
Coeliac disease, often misunderstood or misdiagnosed in children, is an autoimmune condition triggered by the ingestion of gluten—a protein found in wheat, barley, and rye. When a child with coeliac disease consumes gluten, their immune system mistakenly attacks the small intestine, leading to inflammation and damage to the intestinal lining. This impairs the absorption of essential nutrients, which can significantly impact a child’s growth and development.

Why Diagnosis Can Be Difficult in Children
What makes coeliac disease particularly complex in children is that its symptoms can be subtle, varied, or mistaken for other common childhood illnesses. While adults often experience clear gastrointestinal issues, children may show signs that seem unrelated to digestion, making timely diagnosis essential.

Recognising the Symptoms Early
Early symptoms of coeliac disease in children can include chronic diarrhoea, constipation, bloating, abdominal pain, and vomiting. However, non-digestive symptoms such as irritability, fatigue, delayed growth, failure to thrive, anaemia, dental enamel defects, and even behavioural problems may also manifest. Because these symptoms mimic other conditions, coeliac disease can often go unrecognised for months or even years.

The Impact on Growth and Development
One of the most telling indicators is poor weight gain or weight loss despite a healthy appetite. As the small intestine becomes more damaged, it struggles to absorb key nutrients like iron, calcium, and vitamins. This can lead to stunted growth, delayed puberty, and weakened bones. For children, who are in crucial stages of development, early intervention is key to preventing long-term complications.

How Coeliac Disease is Diagnosed
Diagnosis of coeliac disease typically begins with a blood test to check for specific antibodies. If the results suggest coeliac disease, the child is usually referred for an intestinal biopsy, which remains the gold standard for confirmation. It is crucial that a child continues consuming gluten until all tests are complete—removing gluten prematurely can interfere with accurate diagnosis.

The Role of a Gluten-Free Diet
Once diagnosed, the only effective treatment is a strict lifelong gluten-free diet. This means eliminating all foods and products containing wheat, barley, rye, and any derivatives. For families, this can feel overwhelming at first. However, with the right support, including dietitians and paediatric specialists, managing coeliac disease becomes more manageable over time.

Supporting Children in Adapting to Dietary Changes
Parents play a crucial role in supporting their child’s adjustment to this new lifestyle. This includes educating themselves and their child on how to read food labels, identify gluten-free alternatives, and navigate social situations like birthday parties and school meals. Over time, children learn to advocate for their own health needs, making them more resilient and responsible in the long run.

Monitoring Nutrition and Growth
It’s also important to monitor a child’s nutritional intake to ensure they’re not missing out on vital nutrients due to dietary restrictions. Regular follow-ups with a paediatric gastroenterologist, such as Dr. Nawfal, and consultation with nutrition experts can ensure the child remains healthy and symptom-free. Many gluten-free products are now fortified, and with the right guidance, children can maintain a balanced and fulfilling diet.

Finding Strength Through Community Support
Support groups, both online and offline, offer families a valuable network for sharing tips, recipes, and emotional support. Being part of a community that understands the journey of living with coeliac disease can significantly reduce stress and anxiety for both children and their caregivers.

Thriving with Coeliac Disease
Raising a child with coeliac disease does come with challenges, but it also offers an opportunity for families to cultivate healthier, more informed eating habits. With growing awareness and increasing availability of gluten-free options, children today can lead full, active lives without compromise.

FAQs

1. What age can coeliac disease develop in children?
   Coeliac disease can appear at any age after gluten is introduced into the diet, typically after six months of age.
2. Is coeliac disease hereditary?
   Yes, coeliac disease tends to run in families. If a parent or sibling has it, testing other family members is recommended.
3. Can children outgrow coeliac disease?
   No, coeliac disease is a lifelong condition. However, symptoms can be effectively managed with a strict gluten-free diet.
4. What are common hidden sources of gluten?
   Gluten can be found in sauces, soups, processed foods, and even some medications or toothpaste. Reading labels is essential.
5. How soon will symptoms improve after starting a gluten-free diet?
   Many children start to feel better within a few weeks, but complete healing of the intestine may take months to years.