Introduction
Celiac disease is a chronic immune-mediated disorder affecting the small intestine. When someone with celiac disease ingests gluten-containing food, their immune system gets triggered, and it starts damaging the intestinal villi. Villi are tiny, finger-like projections in the small intestine that absorb nutrients from food. Damage to the villi causes the body not to absorb nutrients from meals, resulting in gastrointestinal problems, poor nutrient absorption, and even poor weight gain. Even if a person eats a lot, they will still be undernourished. Celiac Disease among children can hamper their development and growth. The best way to prevent celiac disease is to stop eating food that contains a high amount of gluten.
What are the symptoms of celiac disease in children?
Celiac disease symptoms vary widely according to age. Also, the symptoms of celiac disease can be related to GI or not associated with GI. For example, young children may experience stunted growth, which begins when they consume gluten-containing solid meals around six to nine months of age. GI-related symptoms in young children include diarrhea and gas, whereas GI symptoms in older children and teenagers include abdominal pain, vomiting, and constipation. The symptoms that are not related to GI in older children include delay in puberty, skin rashes, iron deficiency, i.e., anemia that does not respond to iron supplements, increased liver function tests, and osteoporosis. Below are the symptoms that only a specific age group experiences with celiac disease.
Infants and Toddlers
Infants and toddlers have more pronounced symptoms, and they are more or less related to gastrointestinal tracts.
- Bloating
- Vomiting
- Irritability
- Poor growth
- Abdominal distention
- Diarrohea
- Malnutrition
Children of school-going age
Vomiting is less common in this age group of children than infants and toddlers. However, the following symptoms can be seen in school-going children.
- Abdominal distention
- Stomach aches or abdominal pain
- Diarrohea
- Constipation
- Trouble gaining weight or weight loss
Teenagers
Teenagers may experience symptoms or indicative signs unrelated to the intestinal tract, called “extra-intestinal” or “atypical” symptoms.
The following symptoms are some of the signs of celiac disease in children:
- Stunted growth
- Delayed puberty
- Achy pain in the bones or joints
- Chronic fatigue
- Weight loss
- Recurrent headaches or migraines
- Chronic, bumpy, itchy skin rash medically known as Dermatitis herpetiformis
- Aphthous ulcers, which are recurring mouth sores
- Children of this age are sensitive and may suffer from mental health disorders like anxiety and depression, and some may also experience panic attacks.
Severe Celiac Disease Symptoms in Children
The cases of severe celiac disease in childhood are now sporadic. However, the following symptoms are reported in children with severe celiac disease:
- Chronic fatigue
- Very low blood pressure
- Excessive water loss in stool, leading to “electrolyte disturbance.”
- Abdominal obstruction is called “intussusception.”
What Causes Celiac Disease in Children?
Scientists don’t have a valid answer to why celiac disease develops in the early years for some children and some in their adulthood. Scientists believe that the child’s genetics induces a trigger response in the immune system on ingesting food containing gluten. Most of the patients having celiac disease are unaware of their condition. Celiac disease would be more common than Type 1 diabetes if all of these persons were identified.
What Is the Treatment for Celiac Disease?
There is no drug for treatment for celiac disease at present. The only way to avoid celiac disease is to avoid gluten. Complete removal of gluten from gluten-containing food or costly food is not possible. Researchers have found celiac patients to tolerate gluten safely up to 20 ppm. Patients should visit a nutritionist who can modify a person’s diet to eliminate gluten. It would be best if you didn’t begin a gluten-free diet until diagnosed with celiac disease.
Even if symptoms go away completely, reintroducing gluten will again cause severe celiac disease complications to return. Thus, diagnosis of Celiac disease should be made as early as possible to prevent serious health complications. In addition, the patient should religiously practice a gluten-free diet for the rest of their life.
What are the risk factors?
It’s is necessary to screen your child for celiac disease as soon as symptoms appear or if you know that anyone in your family member (a primarily first-degree relative of the patient) has celiac disease. A first-degree relative (parent, sibling, or child) of someone with celiac disease has a one-in-ten chance of developing the condition.
The following are some risk factors for celiac disease in children-;
- Type 1 diabetes
- Autoimmune thyroid disease
- Dermatitis herpetiformis
- Down syndrome
- Turner syndrome
- Williams syndrome
- A relative with celiac disease
- Deficiency of IgA antibody
COVID-19 with Celiac Disease in Children
Celiac disease is not considered an immunocompromised state in children, and it is not recognized as a risk factor for severe disease in and of itself. Children with celiac disease, like everyone else, should adopt good infection control habits issued for COVID-19, such as washing hands with soap or hand sanitizer for at least 20 seconds before going and before coming inside the house. Along with this, they should also wear a mask, maintain social distancing, and take vaccination at the right time. Patients with various medical issues should seek further disease-specific advice from their providers and information from local health authorities.
Conclusion
Some children with celiac disease will suddenly show symptoms that may only last a few hours after consuming gluten. Symptoms in others can linger for several days or even two weeks. Excess gas, stomach pain, or constipation are common symptoms in children that are easy to overlook. In some cases, some children have shown severe signs, such as failure to thrive, weight loss, and vomiting, leading to an early diagnosis. Fortunately, children and adolescents usually react well to gluten-free diet treatment. After two weeks on a gluten-free diet, most children feel considerably better and achieve normal height, weight, and bone health.
There is no medicine to cure celiac disease completely, which makes celiac disease a life-long complication. The best way to prevent Celiac disease is to cut down the ingestion of foods that contain gluten. Children and adults who have celiac disease should avoid wheat, barley, and rye. Instead, the diet should include cheese, milk, yogurt, unprocessed meats, fresh fruits, nuts, oils, gluten-free grains, and starches like corn, potato, quinoa, teff, and millet. Parents should check if their children can tolerate lactose-containing foods like milk, cheese, and yogurt. If lactose intolerance is found, then avoid eating food items that contain lactose.
References
- Celiac Disease. Accessed at https://kidshealth.org/en/kids/celiac.html
- Celiac Disease. Accessed at https://gikids.org/celiac-disease/
- Celiac Disease in Children. Accessed at https://celiac.org/about-celiac-disease/celiac-disease-in-children/
- Celiac Disease in Children & Teens. Accessed at https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/Celiac-Disease.aspx
- Myths about Celiac Disease, Gluten Sensitivity, and The Gluten-Free Diet. Accessed at https://www.beyondceliac.org/celiac-disease/myths/
