It's not commonplace for a child to need a gluten-free diet to stay healthy, but when it's your child, you want the facts and a plan. One in every 130 children is diagnosed with celiac disease, an autoimmune disorder in which gluten (a protein in wheat, rye and barley) inflames the intestines.
Michele Alkalay, M.D., Director of the Pediatric Celiac Disease Program at Children's Health℠ and Assistant Professor at UT Southwestern, says a third of children with celiac disease don't show any symptoms at all. However, there are signs of celiac disease parents or other family members may notice in children.
Celiac disease symptoms in children
1. Chronic abdominal pain
Chronic abdominal pain is pain that occurs for more than three months, though it may come and go during that time. If your child has celiac disease and eats gluten, the gluten can inflame the lining of the intestines, causing this pain.
Since a lot of other problems can cause chronic abdominal pain, too, you should always take your child to the pediatrician if he or she has consistent or long-lasting abdominal pain.
"If the pain is really severe, you should go to the emergency room," says Dr. Alkalay. "If the pain lasts months and impedes your child's daily activity, he or she should be evaluated by a doctor."
2. Constipation
Constipation is a common digestive condition children may have if they don't move their bowels regularly, or when they do go, they have a very hard time using the restroom. Children can develop constipation for many reasons, including celiac disease.
Dr. Alkalay says the number-one cause of constipation is functional problems. Children with functional constipation have no health problems, but can't go because they held it too long, don't get enough fiber nutrients from food or don't drink enough water.
"It's very uncommon for children, especially teens, to get constipated if they are drinking liquids and eating a high-fiber diet," says Dr. Alkalay. "That's when we start checking for problems like celiac disease or thyroid issues."
3. Poor growth
Poor growth can be a subtle symptom of celiac disease. You may notice that your child is not tall enough or big enough when you see him or her standing next to classmates. You might also notice that you've stopped buying new clothes for your child. For instance, your child may not have gone up a size in clothes for more than a year or their clothes seem too baggy or loose.
"Typically, a sign of celiac is someone who is not gaining weight and has a bloated belly," explains Dr. Alkalay.
Screening for celiac disease
Other common symptoms parents might notice include fatigue, chronic diarrhea, skin rashes or anemia. Dr. Alkalay encourages parents to see a pediatrician or specialist to find out if testing for celiac disease is necessary before making any dietary changes. Screening for celiac disease often involves a blood test.
"If you have any suspicion that your child has celiac disease, he or she should get screened with blood work at a pediatrician's office or at a pediatric gastroenterologist's office," says Dr. Alkalay. "It is not recommended to avoid gluten unless it's medically necessary."
While celiac disease is a lifelong condition, symptoms can be managed with a strict gluten-free diet. Dr. Alkalay encourages parents to watch for signs that their child is developing celiac disease to help diagnose and treat the issue early.
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The childhood celiac disease program at Children's Health is the only medical pediatric celiac program in North Texas. Learn more about our gastroenterology programs and services.
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