Celiac Disease in Children
Celiac 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. It is very important to test your child at the very first signs, or if celiac disease runs in your family. First-degree relatives (parent, sibling, child) have a 1 in 10 chance of developing celiac disease themselves.
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.
Celiac disease affects children in different ways, depending on their age
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:
- Vomiting
- Bloating
- Irritability
- Poor growth
- Abdominal distention
- Diarrhea with very foul stools
- Malnutrition
School-Age Children
Vomiting is less common in school-age children than in infants and toddlers. Symptoms include, but are not limited to:
- Stomach aches or abdominal pain
- Abdominal distention
- Diarrhea
- Constipation
- Trouble gaining weight or weight loss
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:
- Stunted growth
- Weight loss
- Delayed puberty
- Achy pain in the bones or joints
- Chronic fatigue
- Recurrent headaches or migraines
- Itchy skin rash (dermatitis herpetiformis)
- Recurring mouth sores, called aphthous ulcers, which look like canker sores
Adolescents with celiac disease may also have mood disorders, including anxiety and depression, as well as panic attacks.
Celiac Disease in Children with No or Mild Symptoms
There are two primary ways that celiac disease can be found in children without symptoms of concern. The first is to have an associated condition in which testing for celiac disease is recommended:
- Family member with celiac disease
- Type 1 diabetes
- Thyroid disease
- IgA deficiency
- Juvenile Chronic Arthritis
- Down syndrome (Trisomy 21)
- Williams syndrome
- Turner syndrome
The second is to have other signs of celiac disease that do not cause typical symptoms:
- Iron deficiency anemia
- High levels of liver enzymes AST and ALT
- Osteopenia (thin bones)
- Dental enamel defects
Severe Celiac Disease in Children
Severe cases of celiac disease in childhood are now very rare. Symptoms of severe cases include:
- Chronic fatigue
- Very low blood pressure
- Excessive water loss in stool, leading to “electrolyte disturbance”
- Abdominal obstruction called “intussusception”
Family Members and Risk
It is very important to test your child for celiac disease at the very first signs, or if celiac disease runs in your family. First-degree relatives (parent, sibling, child) of someone with celiac disease have a 1 in 10 chance of developing celiac disease themselves.