Celiac disease and kids

What is celiac disease?

Celiac disease is a genetic autoimmune disorder triggered by consuming a protein called gluten, which is found in wheat, barley and rye. When someone who has celiac disease eats gluten, the gluten causes damage to the lining of their small intestines (villi). Damaged villi make it very difficult to absorb nutrients into the bloodstream.

In the U.S., about 1 in 133 people have celiac disease.  Unfortunately, a large portion of these people living with celiac disease remain undiagnosed or misdiagnosed.

Common signs and symptoms of celiac disease in children are:

  • Difficulty gaining weight and/or weight loss
  • Abdominal distension, bloating and pain
  • Diarrhea (frequent loose stools) or constipation
  • Vomiting or reflux
  • Fatigue
  • Headaches

There’s a big difference between confirmed celiac disease and non-celiac gluten intolerance. It’s important to distinguish between these as there are very different health implications.

There are some groups of people that are at higher risk of having celiac disease.  This includes people with the following:

  • Type 1 diabetes
  • Down syndrome
  • Turner syndrome and Williams syndrome
  • Selective Immunoglobulin A (IgA) deficiency
  • Autoimmune thyroid disease
  • A first degree relative (a parent, sibling or child) who has celiac disease. There is also a slightly increased risk if there is a second degree relative (grandparents, grandchildren, uncles, aunts, nephews, nieces and half siblings) with celiac disease.

How is celiac disease diagnosed?

If there is a suspicion of celiac disease, blood tests will be drawn. If the results are concerning for celiac disease, the patient will be referred to a gastroenterologist. If celiac diagnosis is suspected, an endoscopy may be done to look at the intestines for confirmation.

If there is any concern for celiac disease, it is essential that the child continues to eat food that contains gluten at least daily until all of the testing is completed. If gluten is prematurely removed from the diet, providers will be unable to confirm the diagnosis of celiac disease.

How do we treat celiac disease?

To learn more about your child’s digestive and dietary needs, talk to their pediatrician or contact OHSU Doernbecher Children’s Hospital at 503-346-0640.

There are no medications needed or currently available for the treatment of celiac disease.

Instead, the treatment of celiac disease is complete elimination of gluten (wheat, barley, rye and contaminated oats) from the diet. Once an individual has  a diagnosis of celiac disease and completely removes gluten from their diet, symptoms can improve within a couple of weeks. It can take up to 6-12 months for the intestines to completely heal after gluten removal.

When a child is diagnosed with celiac disease, we strongly recommend the child and parents work with a pediatric dietician who can provide all of the important dietary information for a gluten-free diet.

 

Chelsea Doherty, M.S.N., R.N., C.P.N.P
Instructor of Medicine
Division of Gastroenterology and Hepatology
OHSU Doernbecher Children’s Hospital

 

Henry Lin, M.D., M.B.A.
Associate Professor of Pediatrics
Division of Gastroenterology
OHSU Doernbecher Children’s Hospital

 

Mikelle Bassett, M.D.
Director, Celiac Program
Assistant Professor of Pediatrics
Division of Gastroenterology
OHSU Doernbecher Children’s Hospital