What is celiac disease in children?

Celiac disease, also known as gluten-sensitive enteropathy, is a chronic digestive and autoimmune disorder that affects the small intestine. This disease occurs due to the immune system's reaction to the protein gluten, found in wheat, barley, and rye, which leads to damage in the lining of the small intestine. This damage hinders the body's ability to absorb vitamins, minerals, and other nutrients from food, potentially leading to malnutrition and other serious health issues [1].

Celiac disease is different from a gluten sensitivity or a wheat allergy. While gluten sensitivity can cause some overlapping symptoms such as abdominal pain and fatigue, it does not damage the small intestine the way celiac disease does. A wheat allergy is a type of food allergy that involves an immune reaction to wheat; however, it manifests with different symptoms like itchy eyes or difficulty breathing and does not cause long-term damage to the small intestine [1].

Causes and Risk Factors of Celiac Disease in Children

The exact cause of celiac disease is not fully known, but research indicates that it occurs only in individuals who have a specific genetic predisposition and consume foods containing gluten [1]. Several factors increase a child's likelihood of developing celiac disease, including a family history of the disease or having certain syndromes, such as Down syndrome, Turner syndrome, or Williams syndrome [1].

Common Symptoms of Celiac Disease in Children

Symptoms of celiac disease can vary from child to child, and some children may not exhibit any symptoms at all. Digestive symptoms are more common in children than in adults [1]. These symptoms include:

• Bloating or a feeling of fullness in the abdomen [1].
• Chronic diarrhea or foul-smelling, fatty stools [1].
• Constipation and gas [1].
• Nausea, vomiting, and abdominal pain [1].
• Failure to gain adequate weight or weight loss [1].
• Irritability in children [1].
• Fatigue, depression, and anxiety [1].
• Bone or joint pain [1].

Diagnosis of Celiac Disease in Children

If a healthcare provider suspects celiac disease, they will collect the child's medical and family history and perform a physical examination. To confirm the diagnosis, blood tests looking for specific antibodies are typically used, along with a biopsy of the small intestine. The biopsy is performed during an upper gastrointestinal endoscopy, where a flexible tube with a camera is used to view the lining of the esophagus, stomach, and small intestine to take a tissue sample [1] [2].

Primary Treatment for Celiac Disease and Growth Challenges

The only primary treatment for celiac disease is following a gluten-free diet (Arabic) for life [1]. Adhering to this diet helps treat or prevent many of the symptoms and other health problems resulting from the disease. In most cases, the diet can also contribute to healing the damage in the small intestine and prevent further harm [1]. The doctor may refer the child to a registered dietitian to help the family learn how to follow a healthy, gluten-free diet [2]. It is essential to avoid all hidden sources of gluten, such as certain dietary supplements, cosmetics, and toothpastes [1].

A gluten-free diet can be challenging, especially with children. Product labels must be read carefully, and in cases where information is not clear, it is advised to check with the manufacturer [1]. A dietitian can help identify safe products and provide advice on how to avoid cross-contamination with gluten, even in restaurants or places that claim to offer gluten-free products [3]. The healthcare provider may also recommend taking vitamin and mineral supplements to correct or prevent any nutritional deficiencies [3].

Medical references

• Celiac Disease
• Celiac Disease
• Celiac disease - nutritional considerations