Celiac disease in children: what do parents need to know?

Coeliac disease is a chronic autoimmune condition triggered by the consumption of gluten, a protein found in wheat, barley and rye. In children with a genetic predisposition, ingestion of gluten triggers an abnormal immune response that affects the small intestine. This inflammatory process can lead to damage to the intestinal villi, small finger-like structures responsible for absorbing nutrients.

Symptoms and diagnosis: how does celiac disease manifest in children?

The spectrum of symptoms in celiac disease is extremely varied, ranging from mild forms with minimal or absent manifestations to severe clinical pictures with significant impact on quality of life. In children, symptoms may be digestive or extraintestinal.

Digestive symptom:

• Chronic diarrhea: frequent, loose, bulky, sometimes foamy or oily stools.
• Abdominal pain: of varying intensity, often after meals containing gluten.
• Bloating: abdominal distension, excessive flatulence.
• Low weight gain or weight stagnation: difficulty gaining weight or slowing down.
• Vomiting: occasional or frequent, especially after eating gluten.
• Lack of appetite: anorexia, refusal to eat.
• Bloody stools: rare but possible in severe forms of the disease.

Extraintestinal symptoms:

• Fatigue: lack of energy, daytime sleepiness.
• Irritability: mood swings, nervousness.
• Developmental delay: delayed puberty, late menarche in girls.
• Anemia: iron deficiency, manifested by pallor, fatigue.
• Dermatologic conditions: dermatitis herpetiformis, a specific skin rash.
• Dental enamel defects: frequent cavities, low resistance to dental treatments.
• Osteoporosis: bone demineralization, increased risk of fractures.

Diagnosing celiac disease is complex and requires a multidisciplinary approach. Pediatric gastroenterologist at Elytis Hospital will perform a thorough assessment of the child's medical history and symptoms, followed by a careful physical examination. Paraclinical investigations may include:

• Serologic tests: determination of specific antibodies (anti-gliadin, anti-endomysium, anti-transglutaminase) in the blood.
• Duodenal biopsy: this is the gold standard for diagnosis, taking a small sample of tissue from the small intestine for examination under the microscope.
• Genetic testing: can identify genetic predisposition for celiac disease.

How does gluten affect a child's digestive system?

In children with celiac disease, gluten triggers an aberrant immune response. Antibodies produced by the body attack intestinal cells, leading to chronic inflammation and damage to intestinal villi. The latter are essential for the absorption of nutrients, and their destruction leads to malabsorption, vitamin and mineral deficiency, and the symptoms mentioned above.

Food alternatives and mini-guide for parents

The only effective treatment for celiac disease is a strict, gluten-free diet for life. Complete elimination of gluten from the diet allows the intestinal lining to heal and symptoms to disappear.

Banned foods:

• Wheat: bread, pasta, pizza, biscuits, cookies, cakes, sauces with ranta.
• Barley: beer, whisky, malt.
• Rye: rye bread, some breakfast cereals.
• Processed foods: sausages, canned meats, semi-prepared foods as they may contain gluten as an additive.

Food allowed:

• Gluten-free grains: rice, corn, quinoa, buckwheat, millet, millet, amaranth.
• Gluten-free flours: rice, corn, tapioca, potato.
• Vegetables and fruit: fresh or frozen.
• Meat and fish: unprocessed.
• Eggs.
• Dairy: milk, yoghurt, cheese (although some people may also be lactose intolerant).

It is essential that parents read food labels carefully to identify hidden sources of gluten. Even small amounts of gluten can trigger symptoms in children with celiac disease.

For further indications, it is important to consult your specialist!

Pediatric gastroenterology at Elytis Hospital: support for child and family

The Elytis Hospitalwe understand the challenges faced by children with celiac disease and their families. Our team of pediatric gastroenterologists provides an accurate diagnosis and a personalized treatment plan tailored to each patient's needs.

Why choose pediatric gastroenterology at Elytis Hospital?

• Specific approach for children: our doctors specialize in treating children's digestive problems, using methods adapted to each stage of development.
• Modern technology: investigations, such as abdominal ultrasound, are performed with high-performance equipment, ensuring accuracy and safety.
• Counseling and prevention: we offer support for parents, including information on proper nutrition and preventive measures for the health of your child's digestive system.

Services offered by Elytis Hospital:

• Gastroenterology consultations and check-ups
• Abdominal ultrasound scans
• Special recommendation: it is mandatory to bring a stool sample for a complete and accurate assessment

At Elytis Hospital, your child's health is our priority. We welcome you with a dedicated and empathetic medical team ready to provide the best diagnostic and treatment services.

Latest medical review:

13.02.2025, Dr. Oana Maria Rosu - Medical Specialist

References:

• Gaur, Sonia. "The Association between ADHD and Celiac Disease in Children." Children, 2022, vol. 9, no. 6.
• Hujoel, Isabel A. (Dr.), et. al. "Celiac Disease. Clinical Features and Diagnosis." Gastroenterology Clinics, 2019, vol. 48, no. 1, pg. 19 - 37.
• Jalilian, Milad, Jalali, Rostam. "Prevalence of celiac disease in children with type 1 diabetes: A review". Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2021, vol. 15, no. 3, pg. 969 - 974.
• Jimenez, Jennifer (Dr.), et. al. "Celiac Disease in Children." Pediatric Clinics, 2021, vol. 68, no. 6, pg. 1205 - 1219.
• Sahin, Yasin. "Celiac disease in children: A review of the literature". World Journal of Clinical Pediatrics, 2021, vol. 10, no. 4, pg. 53 - 71.