Coeliac disease is an auto-immune condition that stops the body from processing gluten (wheat, rye, barley and oats) normally. Gluten is commonly found in foods such as breads, cereals, biscuits and pasta.
The condition causes the villi (small finger-like projections) on the bowel walls to become inflamed and flattened. This damage is called villous atrophy and makes it difficult for the bowel to absorb nutrients.
If untreated, the disease can cause osteoporosis, fertility problems, liver disease, cancer and other auto-immune diseases.
Signs and symptoms
Symptoms of coeliac disease can range from non-existent through to mild or severe, and may include:
- gastrointestinal problems such as diarrhoea, constipation, bloating, flatulence, abdominal pain and nausea
- chronic anaemia (iron deficiency)
- unexplained weight loss or weight gain
- growth problems
- tiredness and irritability
- delayed puberty
- mouth sores
- skin rashes
- joint and bone pain
How is it diagnosed?
Tests will be needed to establish if your child coeliac disease. Your child will need to follow a few steps during the testing process.
- Keep eating gluten. If your child stops eating gluten they may return a false negative on their blood tests. They will need to have a ‘normal’ diet (including gluten) for six weeks prior to testing.
- Blood tests will measure the antibody levels in your child’s blood. Usually these are higher than normal if you have coeliac disease.
- A gastroscopy procedure will be used to take several samples of your child’s bowel. The procedure usually takes around 10 minutes and is conducted under a light anaesthetic. This will enable the specialist to identify if villous atrophy is present in the bowel.
Genetic testing may also be conducted if the other tests return unclear results. These may involve taking a tissue scraping from inside your child’s cheek or additional blood tests. Genetic testing is used mainly to exclude coeliac disease. It is generally NOT useful to make a positive diagnosis and gluten should NOT be excluded based on a positive genetic test.
What is the treatment?
It’s important to remove all gluten from your child’s diet once they have been diagnosed with coeliac disease. This may involve a significant lifestyle change for your child.
Gluten is a commonly found in many products and you will need to pay careful attention to the ingredients lists on all packaged goods. Purchasing foods that a labelled ‘gluten free’ or are naturally gluten free (e.g. fresh fruit and vegetables, unprocessed meats) will also be good options for your child.
A nutritionist or dietician may also be able to provide assistance with food and recipe ideas.
Care at home
Children with coeliac disease should follow a strict gluten-free diet. This will help to heal the small bowel, prevent symptoms and reduce the risk of long-term complications.
In an emergency, always call 000.
If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.
Coeliac Australia | www.coeliac.org.au/