Celiac Disease in Children

What is celiac disease?

Celiac disease is an inflammation in the small intestine that affects children with a genetic sensitivity to gluten. Gluten is found in wheat, rye, barley, and certain kinds of oats. Celiac disease is an autoimmune disease, meaning that the body is attacking itself. Currently, the only treatment for celiac disease is a diet free of gluten.

What are the symptoms of celiac disease?

Celiac disease can manifest in a child in many ways, including:

• Poor growth
• Weight gain
• Gastrointestinal symptoms including pain, diarrhea, vomiting, bloating, and constipation
• Abnormal blood tests showing anemia or increased liver enzymes

There may be no symptoms at all in a child at risk for the disease because of a family of the disease, or the presence of Type 1 Diabetes and certain thyroid conditions.

How is celiac disease diagnosed?

A pediatrician may order antibody (blood) tests for your child to screen for celiac disease. These tests have improved significantly over the past several years, but are not 100%— there is still a chance for a false positive or even false negative test.

If your child has had a positive blood test for celiac disease, your pediatrician will likely give you a referral to a gastroenterologist for an endoscopy. This is the “gold standard” for diagnosing celiac disease.

For an endoscopy to effectively diagnose celiac disease, your child must be consuming gluten. (Removing gluten from the diet allows the bowel to heal and makes it difficult to tell whether or not your child has gluten sensitivity.)

How is celiac disease treated?

The treatment of celiac disease is a gluten-free diet. This involves avoidance of foods that contain wheat, rye or barley, or their derivatives. Pediatric celiac disease experts at Columbia's Celiac Disease Center can assist you in helping your child maintain a gluten-free diet. Regular follow up with a nutritionist and physician with experience in treating celiac disease is very important to make sure that your child's growth is adequate, that symptoms of the disease are resolving, and that the daily diet is balanced and truly gluten-free.