Your child's doctor may be more likely to suspect celiac disease when your child exhibits the "classic" celiac symptoms of copious diarrhea and fatigue, plus abdominal bloating and pain. However, celiac disease symptoms in children can be subtle in some cases, your child may simply not be growing as rapidly as her peers, or she may be irritable and inattentive.
The wide array of possible celiac signs and symptoms (there are more than 200) means that you may want to consider testing for celiac disease in cases where your child doesn't have clear-cut digestive effects... especially if you have a family history of the condition.
Typical Celiac Disease Symptoms in Children Include Diarrhea
Celiac disease frequently is diagnosed in children who suffer from large amounts of smelly diarrhea, plus abdominal bloating and pain. These children often look as if they have malnutrition (which they do); although they are generally very skinny, their stomachs stick out significantly due to the bloating.
Instead of diarrhea, children also can suffer from constipation due to celiac disease. Celiac constipation also occurs with bloating and abdominal pain, and some children may have alternating diarrhea and constipation.
Another "typical" symptom of celiac disease in children is failure to thrive these children fall behind on the growth curve, showing height and weight gain that's significantly below that of their same-age peers. If they remain undiagnosed, these children might wind up with short stature in adulthood due to their celiac disease.
However, children with celiac disease are not always underweight. Another recent study found that almost one in five children were overweight at diagnosis, while 75% were considered normal weight. Most of those children who were too heavy when they were diagnosed lost weight after they began following the gluten-free diet.
Children exhibiting typical symptoms of celiac disease tend to get diagnosed earlier than those who exhibit less typical symptoms, probably because their physicians recognize the possibility of celiac more readily. They also have more celiac-related intestinal damage than children with atypical celiac symptoms.
Atypical Symptoms In Children Include Anemia, Irritability, ADHD
A large minority of children one study showed about 30% exhibit iron deficiency anemia as a primary sign of celiac disease. This anemia, which is thought to occur in both children and adults with celiac because they cannot absorb iron from foods they consume, usually resolves itself fairly quickly once the person is diagnosed with celiac disease and begins following the gluten-free diet.
Many children with undiagnosed celiac also display near-constant irritability, although it's not clear why this occurs. It's possible that they simply don't feel well, or there may be a connection with vitamin deficiencies possibly deficiencies in vitamin B-12 and essential fatty acids, both of which affect mood and neurological function.
Finally, a diagnosis of attention deficit hyperactivity disorder in your child may be an indication that she should be tested for celiac disease. As many as 15% of people with ADHD may have celiac disease, and adopting the gluten-free diet seems to relieve their symptoms of ADHD quickly and thoroughly.
When To Test Children for Celiac Disease?
Like adults, children can develop celiac disease at any time, and so should be tested if they display symptoms... even if those symptoms are subtle or atypical.
In addition, children with close relatives who have celiac also should be tested, even if they don't seem to have any symptoms. It's fairly common to find "silent" or symptomless celiac disease in relatives of recently-diagnosed celiacs, and those people also should adopt a gluten-free diet to avoid future complications of the condition.
Celiac diagnosis usually involves a panel of celiac blood tests looking for specific antibodies. If those come back positive or suggestive of celiac disease, the next step is an endoscopy that looks for intestinal damage.
If your child ultimately is diagnosed with celiac, the only available treatment is a gluten-free diet. The good news: Your child may enjoy a growth spurt once diagnosed, and she may shed any inattentiveness and irritability quickly, too. Many parents find their newly diagnosed child seems much happier, is more energetic and even does better in school once she starts the diet.
Dinler G. et al. Celiac disease in 87 children with typical and atypical symptoms in Black Sea region of Turkey. World Journal of Pediatrics. 2009 Nov;5(4):282-6.
Reilly N. et al. Celiac Disease in Normal-weight and Overweight Children: Clinical Features and Growth Outcomes Following a Gluten-free Diet. Journal of Pediatric Gastroenterology & Nutrition. 2011 Nov; 53(5):528–531.
University of Chicago Celiac Disease Center. Symptoms. Accessed Dec. 12, 2011.
University of Maryland Center for Celiac Research. Celiac Disease FAQs. Accessed Dec. 12, 2011.