When Your Child Has Celiac Disease

Celiac disease is a problem that affects your child’s ability to get nutrients from food. It is caused by a sensitivity to gluten. This is a protein found in many grains. Celiac disease affects tiny fingerlike stalks (villi) in the small intestine. The villi collect nutrients from the food your child eats. But celiac disease damages the villi. Damaged villi can’t absorb enough nutrients, even if your child is eating plenty of food. There is no cure for celiac disease. But it can be managed and the damage reversed.  

Outline of child showing digestive system.

What are the symptoms of celiac disease?

Some children with celiac disease don’t feel symptoms. But many children with celiac feel sick, often after eating. Common signs and symptoms in children include:

  • Abdominal pain

  • Bloating (swollen abdomen)

  • Constipation

  • Greasy, foul-smelling diarrhea

  • Irritable or grumpy mood

  • Loss of muscle mass (muscle-wasting)

  • Not growing well

  • Vomiting

What causes celiac disease?

The cause of celiac disease is not known. It is often passed down in families. It may affect more than one family member. Children may be exposed to gluten for the first time when they begin eating solid foods. This mostly happens between 4 and 6 months of age. But they may not develop the disease right away. It could be years before they start having symptoms. 

Closeup cross section of normal intestinal villi.

How is celiac disease diagnosed?

Tests can be done to find out if your child has celiac disease. These tests may include:

  • Blood and stool tests. These tests can help to rule out other digestive problems.

  • Blood test specific for celiac disease. For the test to be accurate, your child needs to continue eating foods with gluten. The healthcare provider can tell you more.

  • Endoscopy with biopsy. An endoscope is a long, thin tube with a camera on the end. Your child will be sedated during the procedure. It is inserted through the mouth and stomach into the duodenum (the first part of the small intestine). This lets the healthcare provider see inside your child’s intestine. During a biopsy, a tiny sample of tissue is taken from the duodenum. This tissue sample is looked at under a microscope to check the tiny villi for damage. This test must be done during the time your child is still eating food with gluten. This is the only way to see if the presence of gluten is damaging the villi.

How is celiac disease treated?

To treat celiac disease, your child will need to be put on a gluten-free diet. This will let the villi heal and begin to absorb nutrients again. Gluten must be removed, even if your child feels fine and doesn’t have symptoms. If it isn’t, celiac disease can lead to serious health problems. Your child must stay on a gluten-free diet for the rest of his or her life.

Long-term concerns

Over time, children with celiac disease who don’t stop eating gluten can develop health problems. These problems can include a lack of needed vitamins and minerals (malnutrition), bone weakness, and shorter height. If celiac disease isn’t treated, there is an increased risk of intestinal cancer later in life. So it’s important to remove all gluten from your child’s diet. Work with your child’s healthcare provider to learn about sources of gluten in food and other products. Even when treated, the condition may be associated with other diseases, such as diabetes or thyroid conditions. Talk with your child's healthcare provider about other signs or symptoms of illness you should watch for.

Grains that contain gluten

  • Barley

  • Bulgur

  • Kamut

  • Malt

  • Rye

  • Semolina

  • Spelt

  • Wheat

Note: Oats don’t contain gluten, but may need to be avoided anyway. Talk with your child’s healthcare provider.