About coeliac disease

Coeliac disease is a kind of autoimmune disease. ‘Autoimmune’ means that the body mistakenly attacks itself when it senses a particular trigger. With coeliac disease, the trigger is a protein called gluten, which is in wheat, rye, barley and may be also in oats.

Coeliac disease affects the lining of the small intestine, which is covered in villi. Villi are like tiny fingers that stick out from the intestinal lining. If your child has coeliac disease, eating foods with gluten damages the villi. If the villi are damaged, your child’s body can’t absorb nutrients properly.

Coeliac disease affects about 1 in 70-100 people. Both children and adults can develop the condition at any age. In children, this can be as young as around six months, once solids containing gluten are introduced.

Causes of coeliac disease

Coeliac disease can run in families. People with coeliac disease inherit genes from one or both parents that make it more likely they might develop it. But not everyone with these genes will go on to develop the condition.

If you, your child’s other parent or one of your child’s siblings has coeliac disease, your child has around 10% chance of also having the condition.

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

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

When to see your doctor about coeliac disease

If you notice any of the symptoms above and they’re unexplained or last for more than two weeks, you should take your child to see your doctor.

Diagnosing coeliac disease

The first step in diagnosing coeliac disease is a blood test to measure specific celiac antibodies. If your child has a high level of these antibodies, Your doctor will then refer you to a gastroenterologist.

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

A gastroscopy is done under a light anaesthetic and takes about 10 minutes. A flexible tube is passed through your child’s mouth and into her small intestine where small tissue samples are taken.

Doctors can look at these samples to see whether the villi are damaged. If they’re damaged, it means that your child has coeliac disease.

In some cases, your child might need to do a blood test to see if he has the genes that can lead to coeliac disease. This might happen if the other tests are unclear.

Treatment of coeliac disease

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

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

Managing coeliac disease

Even trace amounts of gluten in your child’s diet can damage your child’s small intestine, although your child mightn’t always show signs or symptoms. So sticking to a gluten free diet is very important. Here’s how.

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.

When your child is first diagnosed, it’s important to talk with a dietitian about how to manage a gluten-free diet for your child.

Other important steps include:

Keeping gluten-free food separate at home
Reading labels on all foods
Taking care when you eat out  

Looking for gluten-free alternatives:  There are lots of gluten-free cookbooks to help you come up with some new menu ideas. You might like to ask your dietitian to recommend some reliable recipes, cookbooks and websites. Some children and adults can eat oats without problems and you can discuss this with your doctor.

Even if your child has coeliac disease, she can still have a balanced and nutritious diet.