Celiac Disease and Kids 101

When people with celiac disease eat gluten, their immune system mounts a response that attacks the small intestine. This causes damage to the villi, the finger-like projections in the small intestine responsible for absorbing nutrients from food. When the villi are damaged, the body can’t absorb the nutrients and vitamins it needs to thrive.

“When this happens to children, it can affect their growth and development,” says Julie Block, MD, a pediatrician at Scripps Coastal Medical Center Encinitas.

“This is why it's important for children who are diagnosed with celiac disease to adhere to a gluten-free diet,” Dr. Block says. “Following a gluten-free diet will improve their symptoms, promote healing of their intestine and prevent further problems.”

About three million people have celiac disease in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

The disease can develop at any age, from early childhood well into senior adulthood. It’s unclear why some children become ill early in life while others get sick only after years of exposure. Sometimes surgery, a pregnancy, childbirth, a viral infection or severe mental stress can trigger celiac disease symptoms.

Most people have one or more symptoms. Some may not have symptoms or feel sick. Digestive symptoms are more common in children than adults and can include:

• Abdominal bloating and gas
• Chronic diarrhea
• Constipation
• Pale, foul-smelling stool
• Stomach pain
• Nausea and vomiting

Failure to absorb nutrients during the critical years of growth and development for a child can lead to health issues, such as:

• Delayed puberty in teens
• Delayed growth and short stature
• Irritability
• Weight loss

Research suggests celiac disease is a genetic condition, meaning it runs in families. You are more likely to develop the disease if someone in your family has it.

There are several blood tests available that screen for the disease, and a small intestinal biopsy is performed to confirm the diagnosis.

“The longer it takes to diagnose, the more damage it can cause,” Dr. Block says. “Talk to your pediatrician if your child is showing symptoms.”

While celiac disease is treatable simply by avoiding foods with gluten, this can be challenging to do since gluten is found not just in certain grains, but in many other foods and non-food products.

Gluten, for example, is used as a thickening agent and filler in common products, such as ketchup and ice cream. Many lip balms and lipsticks, hair and skin products, toothpastes, vitamin and nutrient supplements and some medications contain gluten.

However, in recent years, grocery stores and restaurants have added many more gluten-free foods and products, making it easier to stay gluten free.

“Gluten-free bread, pasta and other foods are now easier to find in stores and restaurants,” Dr. Block says. “Still, make sure to read the product labels to be certain. At restaurants, let your server or chef know that you have strict dietary needs.”

The U.S. Food and Drug Administration (FDA) requires that gluten-free claims on food labels must be accurate and meet FDA standards. Gluten-free labels mean that the food contains less than 20 parts per million of gluten, the lowest level that can be reliably detected in foods, according to the FDA.

Some individuals don’t test positive for celiac disease, but they still have adverse reactions to gluten. Unlike celiac disease, gluten sensitivity doesn’t damage the intestine, and there are no accepted medical tests for the condition. The most common symptoms of gluten sensitivity are:

• Mental fatigue
• Fatigue
• Gas, bloating and abdominal pain
• Headache

It’s important to talk with your pediatrician if your child is showing symptoms of celiac disease or is at risk of developing the illness.

“If your child has celiac, your doctor will help find resources to get your child on a gluten-free diet and improve his or her health,” Dr. Block says.