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Gluten intolerance or coeliac disease in children

Child with gluten intolerance or coeliac disease with stomach pain

Gluten intolerance, or coeliac disease, is a bowel disease in which the immune system destroys the intestinal mucosa if the person with coeliac disease eats gluten. Paediatricians do not usually use the word gluten allergy but there are similarities between coeliac disease and allergic disease. Blood tests against transglutaminase antibodies are very helpful in diagnosing coeliac disease.

Gluten is a protein found in wheat, rye and barley

The gluten protein is found in wheat, rye and barley. It is gluten that forms the threads of dough that make wheat bread ferment with bubbles in. That is why gluten-free bread does not get the same airy texture as bread with gluten.

Gluten är inte giftigt eller farligt i sig. Det är bara människor med celiaki som behöver undvika gluten. För alla som inte har celiaki finns ingen anledning att äta glutenfri kost.

Coeliac disease destroys the intestinal mucosa

Tunntarmen är den del av magtarmkanalen som tar upp näring ur maten. Upptaget sker i tarmväggens yta, och för att få så stor yta som möjligt för näringsupptag är tarmen luddig, som en äkta matta ungefär. När ett barn med glutenintolerans äter gluten förstör barnets immunförsvar tarmslemhinnan. Efter en tid är allt tarmludd borta. Tarmslemhinnan blir alldeles platt, och full av vita blodkroppar. Att tarmluddet är borta kallas för för “villusatrofi”.

Normal small intestinal mucosa with small intestine - villi at the top. The image at the bottom is small intestinal mucosa at celiac disease with villus atrophy.

Untreated coeliac disease leads to nutrition deficiencies

Since the function of the intestinal mucus is to increase the ability of the intestine to absorb nutrition, it decreases this ability when the intestinal mucus disappears. When the intestinal mucosa is full of white blood cells that break down the intestinal mucosa, the absorption of nutrients into the remaining mucosa is also not very effective.

Thus, a child with coeliac disease who eats gluten gets nutritional deficiencies despite the fact that the food that the child gets in his mouth is just extremely nutritious. The small intestine is too damaged to absorb nutrients, vitamins and minerals.

The nutritional deficiency causes poor growth and often fatigue, or restlessness, depression in older children and teenagers. Iron deficiency is common, leading to anemia, paleness and fatigue. Vitamin D deficiency is common, which can also lead to fatigue and depression and osteoporosis in the long term, among other things. Puberty does not always start as normal.

När tarmluddet är borta kan också förmågan att bryta ned laktos i mjölk tillfälligt försvinna. Ett barn som plötsligt blir väldigt laktosintolerant ska därför ta blodprov för glutenintolerans. När barn med glutenintolerans äter glutenfri kost försvinner laktosintoleransen.

Symptoms of gluten intolerance

Some children with gluten intolerance get stomach upset. Others get diarrhea or constipation. Many grow poorly and get tired and pale.

Blood test for gluten intolerance

There is a really good blood test that is used in the investigation of gluten intolerance. The sample you take is transglutaminase antibodies. If you take this test in a hospital laboratory, the answer is certain.

If a child has no transglutaminase antibodies (and can produce the antibody IgA, which 98% can), the child is most likely not to have coeliac disease. If the suspicion is large and the symptoms are severe, especially in a child who is not growing, a gastroscopy with biopsy of the small intestinal mucosa can be proceeded, but in most cases it is not necessary.

If a child has very high levels of transglutaminase antibodies, it is very likely that the child has celiac disease. Then you take the test and also a gene test before making a diagnosis.

In order for the blood test to work, you have to eat gluten daily. It is therefore not possible to investigate coeliac disease in someone who has already started with gluten-free diet without starting to eat gluten again.

Gluten-free diet

If a gluten intolerance is found, you need to eat a strict gluten-free diet. Then all the symptoms disappear, the transglutaminase antibodies disappear and the gut grows out again. Thus, if a gluten intolerance is diagnosed, you need to be taught by a dietician how to eat a strict gluten-free diet.

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Gluten intolerance or coeliac disease in children

8 thoughts on “<trp-post-container data-trp-post-id="670">Glutenintolerans eller celiaki hos barn</trp-post-container>”

  1. How early in age can you notice celiac disease? Have a granddaughter of 2 months who is now in hospital due to cascade vomiting. Mom has celiac disease. The doctors suspect milk protein allergy.

    1. Man behöver börja äta gluten först, det har man ju som regel inte gjort vid 2 månaders ålder. Mjölkproteinallergi låter som en rimlig diagnos att misstänka.

    1. Yes, but it is unusual. In order to diagnose, one must do a gastroscopy and biopsy (sampling) of the intestinal mucosa.

  2. Our daughter, seven years, got her celiac disease a couple of weeks ago. She had long complained of stomach pain and was involved in the stomach. My father has ulcerative colitis and my experience with the care is that if the man goes with the children, the doctor listens better, this time also applied to the stomach so there were strong reasons why he should go. The doctor prescribed a lot of samples and quickly they found out that she was lactose intolerant. Shortly thereafter, they reported that they suspected Celiaki. The diagnoses are sometimes related and we started reading about celiac disease. There were several symptoms that were right, the previously so happy girl had turned into a real monster, real outbursts up in the sky and then to crash and blame everything on himself and be really low.

    I have been preparing the whole family in the spring for my daughter to have celiac disease, by cooking lactose-free cottage cheese instead of pancakes, eating more potatoes during the weeks, and baking candy without gluten. What was most difficult was that while waiting for the biopsy to continue with sandwiches, sauce saved with wheat flour and pasta dishes. The daughter's pain was increasing all the time and I got more evidence that it was celiac disease she was suffering from.

    What I see can be difficult is to get little sisters checked regularly. The knowledge is very poor in healthcare is my experience. When I now wanted to be tested (at the urging of the pediatrician) they questioned me, claiming that I had been diagnosed since childhood, the doctor said that "lactose intolerance and celiac disease have nothing to do with each other" and a nurse wondered if I had "infected" "My daughter with gluten intolerance.

    We are very pleased to receive answers to what she suffered from, now we will do everything we can to make her feel good.

  3. Thanks for a great blog!
    Hmm, I can't decide if we should maybe pee for a test for our smallest daughter (4 years) ... That is if the poop is correct, she sometimes says that she has a stomach ache and in recent months she has become so pale … Twice after Christmas, the mother of the day called us when she had diarrhea and basically nauseated you because she did not get to the toilet, but no one in the family has been stomach sick then and none of the times she has had more diarrhea than at dagmamman. When it happened the second time, I contacted BVC to advise and raised gluten intolerance, but "because she follows her curve" so I wouldn't worry about it, was the answer.

    1. Our oldest has a really hard stomach, he doesn't want to do anything, you really have to attract everything and he has the typical gluten stomach, but he also follows the curve and then you obviously do not need to examine the kids 🙁

    2. Before my daughter got her diagnosis, she was stubborn in her stomach, even had to pick her, microlax and various other things, just because the doctors did not want to listen to me as a parent. When she was 9 months, I demanded a weight ball, of which she had lost 1.7 kg in 1.5 months. Then there was momentum for them. She was 11 months old when she got her diagnosis, then her bowel noise was completely gone, there was no clue to the whole thing.
      Today she is 10 years old and feels great, grows so it cracks and is a lovely kid.

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