Sarah Keogh Registered Dietician
April 2024
Coeliac disease is a condition that causes damage to the gut when gluten is eaten. People with coeliac disease can have diarrhoea, stomach pain, constipation and bloating. They can also have fatigue, headaches, dizziness, pins and needles, and skin rashes. Coeliac disease is treated with a strict gluten free diet that reverses the damage caused to the gut and relieves the symptoms.
About 1.7 in every 100 people in Ireland has coeliac disease. Unfortunately, 75% of them are not diagnosed. It can take some people over 14 years to get diagnosed from when they first get symptoms. You can get coeliac disease at any age but what does coeliac disease look like in children?
Coeliac disease can affect lots of different parts of the body. Symptoms can be mild to severe and can vary over time as well. Lots of other things can cause these symptoms so it is important to always talk to your GP and get proper testing before you cut out gluten out of your child’s diet.
Gut symptoms of coeliac disease
Some people will have all of the gut symptoms, but some people can have very mild or even no gut symptoms.
Gut symptoms can include:
- Pain
- Constipation
- Diarrhoea
- Bloating
- Excess gas
- Indigestion
- Belching
- Lactose intolerance
- Fussy eating can also be a sign of coeliac disease in children
Skin Symptoms:
A skin rash called “dermatitis herpetiformis” affects around 10% of people with coeliac disease. It often appears on the outside of both elbows; the outside of both knees; or on both buttocks. However, it can turn up anywhere on the body. It comes up as yellowish blisters that are very, very itchy. Most people scratch them until they bleed so the rash often looks “scabby”.
Nervous System Symptoms:
- Fatigue
- Headaches
- Loss of balance
- Pins and needles/numbness in fingers and toes
- Low mood
Dental Symptoms
- Poor tooth enamel
- Mouth ulcers
Malnutrition
Children with undiagnosed coeliac disease can stop growing as fast as other children. They can be smaller than other children of the same age or smaller than their younger brothers and sisters. Children often stop getting taller – so they can look like they are a healthy weight, and it is only when their growth charts are checked that a slowdown in height and/or weight is spotted. Children may have a delay in starting puberty as well.
Look out for:
- Low weight
- Low height for age
Not tracking with their height or weight on their growth chart (check with your GP or Public Health Nurse to get this checked).
Slow growth – smaller than other children or smaller than younger siblings. Have you had to buy new shoes or clothes as often for this child as for other children? Remember children should be regularly growing out of clothes and shoes.
Low iron, low vitamin B12 and low vitamin D are also more common in children with coeliac disease.
History of Coeliac Disease in the Family
At least 1 in 10 people with a family member who is coeliac, will also have coeliac disease. Children who have a family member with coeliac disease (parents or siblings) should be tested, even if they don’t have any symptoms.
What to do?
If you are concerned about coeliac disease, do see your GP. Write down the symptoms you child is having – it can be helpful to keep track of these over a few weeks. The more information you can bring to your GP, the better. It can be useful to write down and problems with the bathroom – did they have diarrhoea, constipation or complain of stomach pain? Do they have any bloating? Are they very tired? Has their growth slowed down? Are they small for their age?
Sometimes stomach issues can be due to anxiety, but it is important to rule out coeliac disease especially if there are any other symptoms. Sadly, we often have children who spent over a year in pain that was thought to be anxiety before anyone thought to check for coeliac disease.
Do remember that all of these symptoms can have lots of causes and some children are naturally small. That’s why you should never self-diagnose coeliac disease or cut out gluten without seeing your GP. Children must also see a dietitian once they are diagnosed and your GP can refer you.
If you have any questions you can contact the Coeliac Society at info@coeliac.ie
