Coeliac disease in children

Liz Wood Alphabiolabs

By Liz Wood, Health Testing Specialist at at AlphaBiolabs
Last reviewed: 06/03/2024

In this article, we discuss coeliac disease in children including symptoms, diagnosis, and how the condition can be managed in the long term.

What is coeliac disease?

Coeliac disease is an autoimmune disease that develops over time because of a sensitivity to gluten; a protein found in certain cereal grains including wheat, rye, and barley, and commonly used in food products such as cereal, bread, and pasta.

When a person with coeliac disease eats gluten, the body’s immune system attacks its own tissue, causing damage to the gut lining and preventing the body from adequately absorbing nutrients from food.

How common is coeliac disease in children?

According to figures published by Coeliac UK, around 1 in 100 children are affected by coeliac disease.

However, many children with coeliac disease are not yet diagnosed, as the disease can often be mistaken for other childhood conditions due to its symptoms (stomach pain, sickness, bloating, fatigue).

Coeliac disease can also slow growth in children. This means it is especially important for children to be diagnosed early, as late diagnosis can adversely impact growth and development.

What are the symptoms of coeliac disease in children?

The most common symptoms of coeliac disease in children include loose stools (diarrhoea), bloating (including a distended abdomen), constipation (difficulty passing stools), and vomiting or nausea.

Other non-gastrointestinal symptoms include tiredness, weight loss, and dermatitis herpetiformis – a skin rash characterised by itchy, blistering skin, typically on the elbow, knees, and buttocks.

It’s important to understand that these symptoms can vary widely from person to person, and children can experience different symptoms depending on their age. This means that infants and toddlers might experience differing symptoms from those of older school-age children and teenagers.

Undiagnosed coeliac disease is especially dangerous for children, as malnutrition can impact growth (height and weight), and delay puberty.

If your child has any of the symptoms associated with coeliac disease, you should speak to your child’s GP as soon as possible, so that they can investigate further.

Everything you need to know about coeliac disease

What are the symptoms of coeliac disease in children of different ages/stages?

The symptoms of coeliac disease can vary, depending on the age and developmental stage of the child.

For example, symptoms in infants typically emerge during weaning onto solid foods (around 6 months of age), once cereals have been introduced into the diet.

This can include diarrhoea and constipation, but may also include extra fussiness/irritability, poor growth, and failure to thrive as their body struggles to absorb essential nutrients.

Toddlers and young children can experience gastrointestinal issues (diarrhoea or constipation), but may also show signs of delayed growth, behavioural changes, and a failure to gain weight.

Coeliac disease can also put toddlers and young children at risk of anaemia due to poor iron absorption, which can cause extreme tiredness (fatigue).

Symptoms in older children and teenagers may be more varied, and can include delayed puberty, dental enamel defects, and stunted growth.

Symptoms such as fatigue, headaches and mood changes are also more common in this age group, which can affect concentration and performance at school.

Is it possible for children with coeliac disease to show no symptoms?

It is possible for children with coeliac disease to show no symptoms at all. This is known as being asymptomatic or having “silent” coeliac disease.

Research has shown that coeliac disease runs in families. This makes testing even more important for children who have a first-degree relative with coeliac disease (i.e. sibling or parent), as they could be at risk of developing coeliac disease in the future.

Children who do not have symptoms can still test positive for coeliac disease on blood tests or a gut biopsy, even if they are not experiencing any adverse effects.

If your child has a first-degree relative with coeliac disease, a Genetic Coeliac Disease Test can help you find out whether they are at risk of developing coeliac disease in the future, with only a cheek swab sample required.

This simple, non-invasive, and completely pain-free test can be used as the first step towards finding out if your child is at risk of developing coeliac disease, before more invasive diagnostic tests are required.

The results can also be shared with medical professionals to enable a faster diagnosis, should your child have one or both of the genes linked to coeliac disease (HLA-DQ2 and HLA-DQ8).

Early diagnosis is important, especially in children, as coeliac disease can cause serious long-term health issues if left undiagnosed/untreated.

Learn more about the Genetic Coeliac Disease Test

What are the causes and risk factors for children with coeliac disease?

Coeliac disease is an autoimmune condition caused by an adverse reaction of the immune system to gluten.

When a person with coeliac disease consumes gluten, a protein found in cereals including wheat, barley, and rye, the immune system reacts by damaging the gut lining of the small intestine. This makes it difficult for the body to absorb nutrients properly.

This can lead to various symptoms and complications including stomach pain, fatigue, diarrhea, and malnutrition.

Research into the condition has shown that coeliac disease runs in families. This means that children who have a first-degree relative with the condition (i.e. parent or sibling) are at a higher risk of developing coeliac disease in the future.

Children with pre-existing autoimmune conditions are also at greater risk of developing coeliac disease over time. Other conditions that have been linked to coeliac disease include autoimmune thyroid disease and Type 1 diabetes. 

Learn more about conditions linked to coeliac disease

How are children diagnosed with coeliac disease?

Coeliac disease is a serious autoimmune condition, which is why early diagnosis is very important for preventing complications in the future.

Diagnostic testing for coeliac disease usually includes blood testing for antibodies and, depending on the results of the blood test, a gut biopsy to assess any damage to the gut lining.

However, a genetic test for coeliac disease can also assist the diagnostic process. This is because coeliac disease runs in families, and people who have a first-degree relative with the condition (i.e. parent or sibling) have a higher risk of developing coeliac disease in the future.

Almost all people with coeliac disease have either the HLA-DQ2 or HLA-DQ8 genes, making genetic testing an effective method for determining the likelihood of your child developing coeliac disease over time.

The results of a genetic test for coeliac disease can be shared with healthcare professionals, which can be useful when trying to secure a diagnosis more quickly.

It can also rule out the need for more invasive tests if your child does not have either of the genes associated with coeliac disease, as this makes it highly unlikely that they will ever develop coeliac disease.   

Buy a Genetic Coeliac Disease Test

What is the treatment for coeliac disease in children?

There is currently no treatment for coeliac disease, other than adhering to a lifelong gluten-free diet.

This means that children living with coeliac disease must avoid any foods that contain gluten including (but not limited to) bread, pasta, cereals, biscuits, and cakes.

Once a person with coeliac disease removes gluten from their diet, they will typically start to see a significant improvement in their health.

It is important for parents and caregivers of children with coeliac disease to check food labels for the presence of gluten, as many foods (particularly processed foods) include additives and flavourings that contain gluten.

It is also crucial that childcare settings and educational institutions (nurseries, schools) are informed if your child has coeliac disease, so that they can tailor meals and snacks appropriately, and avoid cross-contamination with gluten-containing foods. This also applies for social gatherings outside of the home.  

How can coeliac disease be managed in children?

For children living with coeliac disease, managing the condition involves much more than simply switching to a gluten-free diet.

After all, maintaining a gluten-free lifestyle can be challenging, especially when children are required to mix with their peers in nursery or school settings.

Here are a few things to consider when managing coeliac disease in children:

Education

It helps if children living with coeliac disease, along with their families, have a good understanding of the disease and what it means for their ongoing health and wellbeing.

This is especially true when it comes to understanding how gluten is used in food, the importance of routinely reading food labels, and how to avoid cross-contamination with gluten-containing foods at home.

Coeliac UK is the UK’s leading coeliac disease charity, and has lots of useful resources for parents, teachers and children affected by coeliac disease.

Advocacy

You can advocate for a child/children living with coeliac disease by ensuring their dietary needs are met away from home. This includes the provision of safe meal options when attending educational settings or social gatherings.

Follow-up care and consultation with health specialists

Routine follow-up appointments with your healthcare provider can help you monitor your child’s growth, development and how they are managing a gluten-free diet. These appointments can sometimes include blood tests for any nutrient deficiencies.

Children with coeliac disease are also at an increased risk of experiencing bone problems, due to malabsorption of calcium and vitamin D. For this reason, regular bone health evaluations can be useful for preventing long-term complications.

Specialist dietitians can also help by providing meal plans, recipes, and tips for eating out safely.

The effects of living with coeliac disease can go beyond the impact of a gluten-free diet, especially when children feel different from their peers because of their diagnosis.

Coeliac disease support groups can provide much-needed emotional support for children and their families, where they are able to share experiences, tips, and encouragement.

Some children may also benefit from counselling, to help them cope with the emotional aspects of managing a condition like coeliac disease.

For more information on managing coeliac disease in children, visit Coeliac UK or speak to your child’s GP for further support.

How can I get my child tested for coeliac disease?  

If you have a child who is experiencing symptoms that could indicate coeliac disease (e.g. bloating, flatulence, stomach pains etc.) you should speak to your GP, who will be able to provide guidance on the next steps for testing and diagnosis.

Diagnostic testing for coeliac disease usually includes blood testing for antibodies and, depending on the results of the blood test, a gut biopsy to assess any damage to the gut lining.

However, before undergoing more invasive testing, an at-home genetic test for coeliac disease can help determine whether your child is at risk of developing coeliac disease in the future.

The results of this test can also be shared with your child’s GP, which can be useful when trying to secure a diagnosis more quickly.

An AlphaBiolabs Genetic Coeliac Disease Test is performed by collecting a cheek (buccal) swab DNA sample. This simple, pain-free method of sample collection means that the test can be performed on anyone of any age, from newborn babies to older children and adults.

The test uses Human Leukocyte Antigen (HLA) typing to confirm or rule out the potential of developing coeliac disease by analysing six DNA markers for the HLA-DQ2 and HLA-DQ8 genes.

It’s easy to order your test online now. Alternatively, you can call our Customer Services team on 0333 600 1300 or email info@alphabiolabs.com for more information.

Genetic Coeliac Testing

Order your genetic coeliac test from our award-winning laboratory.

Liz Wood, AlphaBiolabs

Liz Wood

Health Testing Specialist at at AlphaBiolabs

Liz joined AlphaBiolabs in 2021, where she holds the role of Health Testing Specialist.

As well as overseeing a range of health tests, she is also the lead on several validation projects for the company’s latest health test offerings.

During her time at AlphaBiolabs, Liz has played an active role in the validation of the company’s Genetic Lactose Intolerance Test and Genetic Coeliac Disease Test.

An advocate for preventative healthcare, Liz’s main scientific interests centre around human disease and reproductive health. Her qualifications include a BSc in Biology and an MSc in Biology of Health and Disease.

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