Should my child get tested for coeliac disease?

By Dr Jonathan Dudzik

Paediatric gastroenterologist in Ashgrove, Brisbane

Coeliac disease is an autoimmune condition that affects the digestive system. It occurs when the immune system reacts to gluten, a protein found in wheat, rye and barley, causing damage to the lining of the small intestine.

One of the challenges with coeliac disease is that it does not always present in the same way. While some children develop obvious digestive symptoms, others may have much more subtle signs.

What symptoms can coeliac disease cause?

Common symptoms include:

• abdominal pain
• bloating
• diarrhoea
• constipation
• nausea.

However, not every child experiences gastrointestinal symptoms. Some children may present with:

• poor growth
• fatigue
• iron deficiency
• delayed puberty
• changes in mood or behaviour.

Because symptoms can vary so widely, coeliac disease can sometimes go unrecognised for long periods.

Does family history matter?

Yes. Children with a family history of coeliac disease have a higher risk of developing the condition themselves.

For this reason, doctors may have a lower threshold for testing if a child develops symptoms that could be consistent with coeliac disease.

An important point about testing

One of the most important things parents should know is that children need to be eating gluten before coeliac disease testing is performed.

It can be tempting to trial a gluten-free diet when symptoms occur. However, removing gluten before testing may affect the results and make diagnosis much more difficult.

If coeliac disease is suspected, it is best to discuss testing with your GP before making significant dietary changes.

How is coeliac disease diagnosed?

Testing usually begins with blood tests arranged by your GP.

Depending on the results, referral to a paediatric gastroenterologist may be recommended to confirm the diagnosis and discuss ongoing management.

The good news

When diagnosed early, coeliac disease can usually be managed very successfully with a gluten-free diet.

With appropriate treatment and follow-up, most children go on to grow, develop and thrive.

If your child has ongoing gastrointestinal symptoms, poor growth, unexplained iron deficiency or a family history of coeliac disease, it may be worth discussing testing with your doctor.