Celiac disease in children is an autoimmune condition where the body is unable to tolerate a protein called gluten. This genetic condition tends to run in families, though it may have environmental causes as well.
Koyel Jain, mother of a 4-year-old girl, Maya, was worried as her child would have diarrhea occasionally and poor weight gain.
“Over time, my son’s height was visibly shorter and he wasn’t growing well. When he seemed paler and more irritable as days passed, I decided we needed to consult a pediatrician,” recalled Koyel.
Maya was diagnosed with celiac disease by a simple blood test at her check-up and referred to Dr. Nidhi Rawal, Pediatric Gastroenterologist at Sitaram Bhartia Hospital, for more specialized care.
“This condition begins slowly with the introduction of gluten in the diet and is often unsuspected for years. Timely celiac disease diagnosis and a gluten free diet can reverse the ill-effects that the child has been experiencing,” reassured Dr. Nidhi.
Koyel was unsure as to what it meant for a child to live with celiac disease. Dr. Nidhi clarified her doubts to help her understand Maya’s condition.
What Happens When You Have Celiac Disease?
Gluten is a protein usually found in grains such as wheat, rye and barley.
When children dealing with this condition eat gluten, their body’s immune system attacks the small intestine and damages its ability to absorb nutrients including proteins and iron.
“This lack of nutrients in the body can lead to various gastrointestinal problems and growth delays and anemia.”
Celiac disease affects children differently, according to their age.
The following celiac disease symptoms manifest more obviously in infants and toddlers:
- Chronic diarrhea
- Abdominal pain or cramps
- Poor appetite
- Stunted growth
- Poor weight gain
In addition to the above, older children (above the age of 5 years) may also present symptoms not associated with the gastrointestinal tract such as:
- Delayed puberty
- Chronic fatigue
- Recurrent headaches or migraines, or seizures
- Weight loss
- Dermatitis herpetiformis (itchy rash skin)
- Mood disorders such as anxiety, depression or panic attacks
Children with the following conditions have a higher risk of developing celiac disease:
- Type 1 Diabetes Mellitus
- Williams syndrome
- Down syndrome
- Other autoimmune conditions
Koyel was relieved she reached out to the doctor in time before her daughter’s symptoms worsened.
How Serious Is Celiac Disease In Children?
Koyel was concerned if Maya’s condition could result in any possible complications.
“Celiac disease can cause serious harm to your child’s intestines if left untreated. This could put your child at risk of developing anemia, weak and brittle bones (osteoporosis), growth problems, etc.”
Without proper management, the damage to their intestines can become life-threatening and lead to small intestine cancer.
“But what can trigger celiac disease?” asked a worried Koyel. She wondered if there were any preventive measures she could have taken.
“Celiac disease cannot be prevented as the condition is caused due to genetic as well as environmental reasons. Research is also being done to understand celiac disease causes better,” said Dr. Nidhi.
“We usually advise family members of patients to be tested for celiac disease.”
Celiac Disease Treatment
“Celiac disease cannot be cured but it can be treated completely by a strict gluten free diet.”
There are no side effects of a gluten free diet and no medications are needed to treat celiac disease.
“Once understood completely, a gluten free diet can be easily put together at home, school and restaurants.”
Dr. Nidhi further explained, “We conduct follow-up consultations with our patients every 1-3 months for the first year of diagnosis in order to help them adjust to these lifestyle changes.”
Here are some things Koyel was advised to keep in mind for celiac disease management:
1. Eliminate gluten-containing grains from the diet
The first step to managing this condition is knowing what your child can or cannot eat.
2. Opt for gluten-free diet alternatives
Eating gluten-free foods in a country where roti (made of wheat) is one of the essential food items consumed by the masses may seem difficult, but it is not.
In reality, you can establish an effective and personalized diet with the help of your gastroenterologist. You may switch to gluten-free Indian food alternatives such as:
- Rice, rice flakes (chirwa) or puffed rice (murmura)
- Pulses, lentils and soyabean
- Rice noodles
- Fresh milk and milk products such as buttermilk (lassi), cottage cheese (paneer)
- Freshly cooked and home-made meat, fish, and eggs
Your doctor can help with gluten-free alternatives to common food recipes, which will make sure that your child’s quality of life is not compromised.
3. Be stringent about maintaining a gluten-free lifestyle
- Keep dishes for children separate: Cooking dishes and appliances for children with celiac disease should be kept separate from the rest of the family members. This includes toasters, pans, pressure cookers, ovens etc.
- Read the labels for processed foods before eating: Many processed foods use gluten as an ingredient in them. Avoid accidentally introducing gluten to your child’s diet again by reading the labels before buying.
- Avoid using everyday items with gluten: Gluten is found in more than just food items. It is advised that you opt for gluten-free alternatives
ofthe following items:
- Prescription and over-the-counter medication
- Nutritional supplements
- Cosmetic products such as lipstick, lip balm, etc.
- Body hygiene products such as shampoo, conditioner
- Dental hygiene products such as mouthwash and toothpaste
- Playdough and paints
4. Join supportive counselling with your child
Living with celiac disease can be a major lifestyle change for many and there can be challenging times for your child to stick to a strict diet.
“We help you create an informed support system by educating the child’s extended family members, helpers at home as well as teachers in school. We provide resources to the family in order to help them adjust to a gluten-free lifestyle.”
As Koyel came to understand that celiac disease in children is a lifelong condition, she realised that treatment included major changes in her daughter’s lifestyle.
“I was worried in the beginning, but I started feeling more confident about establishing a
“Now, not only is my child’s condition completely under control but she is also growing well and able to lead a normal, active life.”