The damage to the mucosa lining of the small intestine is the same for both children and adults. There appears to be a rapid loss of cell surface with the result, even with increasing cell recovery, it is unable to keep up. The loss of absorptive surface cells of the mucosa of the small intestine results in failure to digest and absorb food from the small intestine into the blood.
In children, this malabsorption may also cause bone problems because of lack of calcium, varying levels of abdominal distention, vomiting, muscle wasting, and failure to properly grow and develop. Celiac disease presents a wide spectrum of symptoms.
In the person with celiac disease, products derived from wheat, cannot be digested. Products produced from barley, rye, and oats cause the same immune response. The continued consumption gluten in a person who is affected with celiac disease causes a reaction that destroys the villi in the small intestine, resulting in malabsorption of vitamins, minerals, proteins, amino acids, sugars, and fats.
The symptoms of celiac disease in children may become apparent three to five months after first consuming foods containing gluten although for some few cases, the interval may be as short as one month. Talk to your pediatrician about when to introduce solid foods into your baby’s diet. The general consensus is 5 months, but if there is a family history of celiac, your doctor may have different guidelines to follow.
The celiac, but otherwise normal baby, thrives until gluten is introduced into the diet and then begins to refuse feedings and fails to gain weight. The child may gradually become irritable or listless and develop a large abdomen. The stools will typically become abnormal, perhaps large, pale and offensive, or representative of a loose like diarrhea. Stools generally float because of the high content of air and fat.
The child may also vomit from time-to-time or in some cases exhibit forceful projectile vomiting with the consumption of foods containing gluten. Many children lose weight or have a failure to gain weight and the buttocks become flattened. A few children may become quite ill with acute diarrhea and dehydration. Symptoms vary and are different from one celiac child to the next with no two being alike in how the condition “acts out” for them and in their bodies.
Older children with more subtle symptoms of poor appetite, poor growth, and anemia are much more difficult to diagnose as there are many other reasons for failure to grow in childhood. Clinical symptoms may diminish or disappear during puberty [adolescence], although damage to the mucosa may persist. More active symptoms will again reoccur in early adult life following the period when the immune system appears to “give more of its attention” to sexual development. While the teen may feel that he or she has “grown out of the disease,” the actuality is that the condition continues and must be treated with the same strict gluten free diet.
Personality changes may occur in children with celiac disease; selected children may become unable to concentrate, be irritable, cranky, and have difficulties with mental alertness and memory function; however, the same process may also occur in teens and adults. Before removal of gluten from the diet, celiac patients may experience selected neuro-psychiatric symptoms including mood changes, irritability, and depression.
The genes that determine celiac disease can come from one or both parents in the blood line. In 2-15% of families in which one parent has celiac disease, multiple members will have the potential to develop the condition. Most researchers indicate that same family siblings appear to have a 30-40% risk of developing celiac disease. A family history of celiac disease alone is not sufficient to cause the condition to be activated.
For most families, it is typically best if the entire family is on the gluten free diet. If all main dishes can be the same, much of the feeling of being different in the home will be removed. Celiac disease is a lifelong condition.
The only way to 100% treat celiac disease is to feed your child a gluten free diet at all times. Thankfully, gluten is not a dietary nutrient. Your child can still eat fruit, vegetables, fish, meat, milk, eggs, cheese, and breads that are marked as gluten free.
For additional information, you’ll want to check out our Children with Celiac Disease page!