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Celiac Disease and Wheat Allergy in Kids: Symptoms, Causes and Treatment

Celiac Disease and Wheat Allergy in Kids: Symptoms, Causes and Treatment

Celiac Disease/Wheat Allergy in Kids

Celiac disease, derived from the Greek word ‘koiliakos’ meaning “abdominal,” is a lifelong allergy to gluten. This condition may develop any time after gluten-containing foods, such as wheat, are introduced into the diet, usually presenting after 9 to 12 months of age.

What Is Celiac Disease?

Celiac Disease

It is an autoimmune disorder brought on by an allergy to gluten, a class of proteins in wheat, rye, and barley.

The classical symptoms of celiac disease include loose stools (chronic diarrhea), gaseous abdominal distension, and poor growth. Other common presenting features include paleness of the body, vitamin deficiency, and other signs secondary to malabsorption.

Atypical presenting features include aphthous stomatitis, recurrent abdominal pain, vomiting, constipation, abnormal liver enzymes, dental enamel defects, neuropathy, dermatitis herpetiformis, etc.

Younger children especially in the first decade present with classical features, primarily affecting the gastrointestinal system. Whereas, atypical disease presentation is seen in older children after the first decade or so. 

What Causes Celiac Disease?

In celiac disease, gluten activates the immune system to attack and damage the villi—tiny, finger-like projections that line the small intestine and are responsible for absorbing nutrients from food into the bloodstream. When these villi are damaged, they cannot effectively absorb carbohydrates, proteins, and essential vitamins and minerals needed for a child’s growth. 

In our country, it is seen mainly in the North Indians, who have a favorable genetic makeup and eat a predominantly wheat-based diet. Table 1 shows associated conditions which predispose to having an increased risk of celiac disease in children.

Table 1:

  • Other Autoimmune diseases like Type 1 Diabetes mellitus
  • Down’s syndrome
  • First degree relatives
  • Selective IgA deficiency
  • Dermatitis herpetiformis
  • Unexplained elevation of liver enzymes
  • Refractory iron deficiency anemia
  • Primary biliary cirrhosis
  • Short stature etc.

How Is Celiac Disease Diagnosed?

A blood test to check for antibodies [Serum anti-tissue transglutaminase antibody (anti-ttg IgA) and serum IgA] to gluten is typically the first step in diagnosing celiac disease. After that, an upper gastrointestinal endoscopy with a biopsy—a small tissue sample taken from the small intestine—is performed for microscopic examination.

A pediatric gastroenterologist will use an endoscope to examine the child’s small intestine and collect the sample.

Complications Associated with Celiac Disease

Celiac disease patients can experience issues related to absorbing iron, calcium, folate, and other vitamins and minerals. Iron deficiency anemia and reduced bone density may result from this. Short stature, delayed puberty, and increased gastro-intestinal malignancies like lymphoma, etc. are its other complications.

What are the treatment options for celiac disease?

The sole treatment for celiac disease is lifelong adherence to a strict gluten-free diet. This approach enables your child’s intestines to heal and, in nearly all cases, relieves symptoms associated with celiac disease.

The Following Tips can help you choose Foods:

Start with foods your child can eat safely. These include foods made with flour from corn, rice, peas, dal, and potatoes. Plain meats, fish, chicken, beans, nuts, seeds, oils, milk, cheese, eggs, fruits, and vegetables are also safe. Oats may not be safe as they are usually stored/handled along with wheat.

Be careful of cross-contamination, and keep separate utensils and kitchen. Also, before buying any product kindly check on the gluten-free label. Be on regular follow-up’s with your doctor and dietician, and engage with celiac support groups.

Conclusion

Celiac disease is caused by an autoimmunity to gluten; requiring lifelong management through a strict gluten-free diet. To resolve symptoms and encourage healthy growth in children, early diagnosis and dietary adherence are essential. If you suspect your child may have celiac disease, consult with a pediatrician to develop an appropriate plan for diagnosis and treatment.

FAQs for Celiac Disease and Wheat Allergy in Kids: Symptoms, Causes and Treatment

Celiac disease is an autoimmune disorder triggered by consuming gluten, a protein in wheat, rye, and barley, which damages the small intestine.

While celiac disease is an autoimmune disorder, a wheat allergy is an immune response to wheat proteins that may cause symptoms such as hives, swelling, or difficulty breathing but doesn’t damage the intestines.

In infants and toddlers, symptoms often include vomiting, bloating, irritability, diarrhea, poor growth, and malnutrition.

Older children may experience symptoms beyond the digestive system, such as delayed puberty, joint pain, fatigue, recurring headaches, skin rash, or mood issues like anxiety and depression.

The exact cause is unknown, but it is likely due to genetic factors. Children with a family history of celiac disease or related conditions are at higher risk.

Diagnosis usually begins with blood tests for gluten antibodies, followed by an intestinal biopsy to confirm intestinal damage.

The only treatment is a lifelong gluten-free diet, which helps heal the intestines and prevent symptoms.

Choose safe foods, such as rice, corn, and potatoes, and avoid cross-contamination by using separate kitchen tools and cleaning surfaces thoroughly.

Untreated celiac disease can lead to iron deficiency anemia, bone density loss, and growth delays due to poor nutrient absorption.

Yes, with proper diet management and support, children with celiac disease can live healthy, active lives. Regular follow-ups with a healthcare provider are recommended to monitor their health.

Dr. D Venkata Umesh Reddy
Author: Dr. D Venkata Umesh Reddy

Consultant Pediatric Gastroenterologist and Hepatologist

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