About coeliac disease

Coeliac disease is an autoimmune disease. It happens when the body has an abnormal immune response to gluten, a protein found in wheat, rye, barley and oats.

When people with coeliac disease eat gluten, their bodies mistakenly attack the lining of their small intestine. When the lining of the small intestine is damaged, it’s hard for people to digest and absorb nutrients properly. This can affect physical health, weight and growth.

Coeliac disease can develop at any age. In children, it can be around 6 months or when solids containing gluten are introduced.

Signs and symptoms of coeliac disease

Coeliac disease can cause many different signs and symptoms.

If your child has coeliac disease, signs and symptoms might include:

• nausea, vomiting, diarrhoea or constipation
• poor appetite
• stomach pain
• mouth ulcers
• anaemia
• delayed growth or late puberty
• weight loss
• tiredness and irritability.

Does your child need to see a doctor about coeliac disease symptoms?

Yes. You should take your child to see your GP if your child has any of the symptoms above and you don’t know why, or the symptoms last for more than 2 weeks.

Diagnosing coeliac disease

If you’re concerned about your child’s symptoms or you think your child might have coeliac disease, getting a proper medical diagnosis is important.

The first step in diagnosing coeliac disease is a blood test. This test measures specific antibodies in your child’s blood. If your child has a high level of these antibodies, it might mean that they have coeliac disease. Your GP will then refer you to a gastroenterologist.

The gastroenterologist will do a gastroscopy to confirm that your child has coeliac disease.

In a gastroscopy, a flexible tube is passed through your child’s mouth and into their small intestine where small tissue samples are taken. It’s a very safe and quick procedure. It’s done under a light anaesthetic and takes about 20 minutes.

If you think your child has coeliac disease, it’s important not to remove foods with gluten from their diet before they have tests to diagnose the condition. Your child needs to be eating foods with gluten so the tests can check how their body is reacting to it.

Treatment of coeliac disease

There’s currently no cure for coeliac disease. But it can be managed with a strict, lifelong, gluten-free diet.

Once your child stops eating gluten, their small intestine can heal and they should start to feel better, usually within a few days or weeks.

If your child is low on some nutrients, your health professional might recommend that your child takes a supplement for a few weeks or months.

If coeliac disease isn’t diagnosed and treated, it can cause severe long-term health problems, including malnutrition, lactose intolerance, osteoporosis, arthritis, liver disease, epilepsy, infertility and cancer.

Gluten-free diets and coeliac disease

Sticking to a gluten free diet is very important. This is because even trace amounts of gluten in your child’s diet can damage your child’s small intestine.

Removing foods with gluten from your child’s diet
Gluten is found in wheat, rye, barley and oats, so you can start by cutting out foods made with these ingredients. These foods might include:

• bread
• cakes
• biscuits
• breakfast cereals
• pizza bases
• pasta
• pastry
• crumbed or battered food.

Keeping gluten-free food separate at home
In your home, it’s important to keep gluten-free foods separate from gluten-containing foods, so your child with coeliac disease doesn’t accidentally eat gluten. Here are some tips:

• Prepare and store all gluten-free foods away from foods with gluten.
• Use separate chopping boards and utensils when preparing or cooking gluten-free foods.
• Clean utensils and appliances that might have gluten-containing foods or crumbs on them.
• Consider a separate toaster for gluten-free breads.

Reading labels on all foods
There can be hidden gluten in many foods, including sauces and soups. There can also be hidden gluten in non-food products too, like medicines, supplements and playdough. This means it’s very important that both you and your child learn to read labels.

Most packaged foods must list ingredients with gluten on the ingredient list. You can also look out for the crossed grain logo on food packages. This means the food is OK for people with coeliac disease.

Taking care when your child eats away from home
Eating out is an important social activity that your child can still enjoy. But you and your child need to take extra care so that your child doesn’t mistakenly eat any foods with gluten.

Many restaurants flag gluten-free items on their menus. But it’s still a good idea to let staff know that your child can eat only gluten-free food.

It’s also good idea to let your child’s preschool or school know that your child can’t have any foods with gluten.

Looking for gluten-free alternatives
You can make or buy alternatives to most foods with wheat, rye, barley and oats. And you can check out gluten-free cookbooks for new menu ideas.

Even if your child has coeliac disease, they can still have a balanced, nutritious and interesting diet. It’s a good idea to talk with a dietitian about managing your child’s diet. The dietitian can also recommend reliable recipes, cookbooks and websites.

Causes of coeliac disease

Coeliac disease can run in families. Parents can pass on genes that make it possible for their children to develop coeliac disease. If you, your child’s other parent or one of your child’s siblings has coeliac disease, your child has a 10% chance of also having the condition.

Environmental factors probably play a role in the development of coeliac disease too. For example, some types of viral gastroenteritis and some medicines might make it more likely that your child will get coeliac disease.

If you or someone in your family has coeliac disease, it’s a good idea to get your child tested for this condition too.