From constipation to diarrhea, children are no strangers to digestive issues. Tummy issues in children can come and go, but some digestive problems require medical attention. Poor weight gain is often a sign that something more serious is to blame.

Celiac disease is an autoimmune digestive condition that damages the small intestine. Over time the damage causes problems with the absorption of nutrients, resulting in poor weight gain. Knowing the warning signs to look for can help parents identify potential celiac symptoms in their children.

What is celiac disease?

Celiac disease may develop any time after wheat or other gluten containing foods are introduced into the diet, typically after 6-9 months of age. It is unknown why some children become ill early in life and others fall ill only after years of exposure. It is very important to test your child at the very first signs, or if celiac disease runs in your family. First-degree relatives (parent, sibling, child) have a 1 in 10 chance of developing celiac disease themselves.

Poor weight gain in children

The team of pediatric gastroenterologists and our nurse practitioner work together through our gastroenterology program to diagnose celiac disease. Children are often referred to us here at the Center for Pediatric Gastroenterology and Nutrition for evaluation for poor weight gain. There are a variety of potential reasons for poor weight gain, including malabsorption, picky eating, and reflux.

Our team needs to review your child’s growth charts and medical history to determine whether their growth is normal. Abnormal growth due to a reduced ability to absorb nutrients can have various causes, including food allergies, celiac disease, metabolic disorders, and pancreatic insufficiency.

If you notice that your child is having trouble gaining weight, bringing your child in for an evaluation is a good first step. Poor weight gain can be a symptom of celiac disease. However, it’s important to seek professional evaluation and avoid unnecessarily implementing a gluten-free diet without a diagnosis.

Celiac symptoms in children

Symptoms of celiac disease can vary widely. Some children show warning signs during infancy upon the introduction of cereal. Other children may have no noticeable symptoms, or slow growth may be the only red flag. Many children with celiac disease experience digestive symptoms such as:

  • Lack of appetite
  • Abdominal pain
  • Diarrhea
  • Vomiting
  • Constipation

Some children experience behavioral changes, including irritability. Celiac disease is more common in children with other autoimmune diseases.

Diagnosing celiac in children

Our pediatric gastroenterologists perform blood tests to screen for celiac in children who have symptoms or risk factors for the disease. Blood tests look for certain antibodies related to an autoimmune response to gluten. The blood tests measure:

  • Immunoglobulin A (IgA)
  • IgA anti-tissue transglutaminase antibodies (tTGA)
  • IgA anti-endomysial antibodies (AEA)

Additionally, blood tests can help determine whether your child has enough nutrients essential for growth and development, including folate, vitamin D, and iron. The doctor may order additional tests, such as blood tests to look for thyroid antibodies, a common occurrence in children with celiac.

If your child has a positive antibody blood test, the doctor may recommend an endoscopy with a small intestinal biopsy. This is the only way to confirm celiac disease. During the procedure, the doctor takes a tissue sample from the small intestine to look for certain changes in the villi that indicate celiac disease.

Sometimes a genetic test is done for celiac disease. The test checks for genes present in most people with celiac disease.

Non-celiac gluten sensitivity

Celiac disease is different from gluten sensitivity. Children with non-celiac gluten sensitivity may have similar symptoms to those with celiac disease, such as abdominal pain. Unlike celiac disease, gluten sensitivity doesn’t cause damage to the small intestine.

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