HealthInfo Canterbury
Diagnosing & treating coeliac disease in children
Whakamātaunga me whakataunga mate wīti ki ngā tamariki
If you think your tamaiti (child) has coeliac disease, talk to your family doctor. Tell your doctor if a relative has coeliac disease.
Your tamaiti child may need testing for coeliac disease. Diagnosing coeliac disease accurately is important because coeliac disease is a life-long condition.
Coeliac serology blood test
Coeliac serology measures gluten-fighting antibodies in the blood to see if your tamaiti has coeliac disease. These antibodies are often higher in people with untreated coeliac disease.
Your tamaiti must be eating gluten for about six weeks before the test. During this time, they'll need to eat a minimum of two slices of wheat-based bread (or equivalent) daily.
This flyer from Education in Nutrition describes the types of gluten-containing foods your tamaiti should eat for accurate coeliac disease testing.
Your doctor may also check for some vitamin and mineral levels in your child's blood, particularly iron.
If coeliac serology is positive, your doctor will arrange for your tamaiti to have further tests. These can include:
- another blood test
- a biopsy at the hospital.
Some tamariki (children) may be able to get a coeliac diagnosis without a biopsy. Your family doctor or paediatrician will talk with you about this.
HLA gene testing blood test
Not all tamariki children need HLA testing. It can be useful if there is uncertainty about your child's diagnosis. The gene test alone can't diagnose coeliac disease.
Biopsy
Biopsies are done with a procedure called gastroscopy. This is a simple day procedure but your child will need an anaesthetic.
The doctor uses a flexible tube with a camera attached to its end (called an endoscope). The doctor feeds the tube through your child's mouth into their stomach and then their small bowel. The doctor takes several tiny samples (biopsies) of your child's small bowel.
Laboratory staff then examine the biopsies under a microscope to confirm whether your tamaiti has coeliac disease. It can take a week or two to get the results.
Treating coeliac disease in children
The only treatment for coeliac disease is for your tamaiti child to follow a strict gluten-free diet. This allows the villi in the bowel to regrow. After removing all gluten from their diet, your tamaiti will return to normal health over a few months.
If your tamaiti has had low levels of iron or other vitamins or minerals, they may need to take a supplement until their gut heals.
A gluten-free diet means removing foods that contain gluten including wheat, barley, oats and rye from your child's diet.
Your tamaiti with coeliac disease needs to be on a gluten-free diet for life. Your child's diet needs to exclude all sources of gluten. Eating small amounts of gluten can cause further damage to your child's gut and affect their growth even though it may not lead to symptoms.
It's important to meet with a dietitian to learn and get the right advice about a gluten-free diet.
At an appointment with the dietitian you would expect to discuss and cover:
- foods that contain gluten, including hidden sources of gluten and cross-contamination
- alternative gluten-free foods, including advice on school lunches, eating out and travel
- gluten-free foods on prescription – what's available and how to get repeat prescriptions
- how to read labels so you know if a food contains gluten
- gluten-free recipes, including information on how to adapt recipes that include gluten
- how to make sure your tamaiti gets all the nutrients they need to grow and be healthy on a gluten-free diet
- dietary advice about any related conditions your tamaiti might have. These might include diabetes, lactose intolerance and irritable bowel syndrome.
You'll need to replace many common foods with gluten-free alternatives. These include:
- breads
- crackers
- biscuits and cakes
- cereals
- pasta and noodles.
Your tamaiti shouldn't be on a gluten-free diet unless testing has confirmed that they have coeliac disease. If your tamaiti doesn't have coeliac disease and you take gluten out of their diet, there is a risk of them developing an allergy to gluten-containing grains.
On the next page: Helping your child live with coeliac disease
Content shared between HealthInfo Canterbury, KidsHealth and Health Navigator NZ as part of a National Health Content Hub collaborative. Last reviewed February 2022.
Review key: HICDC-16032
