HealthInfo West Coast-Te Tai Poutini
Overview of coeliac disease in children
Mate wīti ki ngā tamariki
Coeliac (sometimes spelled celiac) disease is an autoimmune disease. It is caused by an abnormal reaction by your child's immune (infection-fighting) system to gluten. Gluten is a protein in wheat, barley, rye and oats.
Your child's immune system mistakes gluten as a threat to the body. To protect the body from the threat, the immune system creates special gluten-fighting antibodies to fight it.
If your tamaiti (child) has coeliac disease, these gluten-fighting antibodies damage the lining of the small bowel.
The small bowel is lined with tiny finger-like projections called villi. Villi break down and absorb nutrients in food. In coeliac disease, gluten damages the villi. They become flattened and the surface area of the bowel decreases. This interferes with the absorption of nutrients from food. This means your tamaiti may not absorb enough vitamins (such as folic acid) and minerals (such as iron and calcium).
These diagrams show where the small intestine is and the damage that happens to the small intestine lining in coeliac disease.
About 1 in 70 New Zealanders may have coeliac disease. Up to 80 percent of them do not know they have it. It is more common in people of European descent but can affect anybody. It can affect tamariki (children) of any age after they start eating foods containing gluten.
Close relatives of someone with coeliac disease have an increased risk of developing the disease. Coeliac disease can also develop in tamariki with other autoimmune conditions. For example, type 1 diabetes and thyroid disease. It is also more common in tamariki with chromosomal conditions such as Down syndrome.
If your tamaiti has coeliac disease, they will need to follow a strict gluten-free diet for the rest of their life. This is even if they do not have any symptoms caused by eating gluten.
Symptoms of coeliac disease in children
Tamariki with coeliac disease may have some of the following symptoms but may also have none at all:
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Diagnosing coeliac disease in children
If you think your tamaiti has coeliac disease, talk to your general practice team. Tell them if a relative has coeliac disease.
Your tamaiti may need testing for coeliac disease. Diagnosing coeliac disease accurately is important because coeliac disease is a lifelong condition.
Coeliac serology blood test
Coeliac serology measures gluten-fighting antibodies in the blood. These antibodies are often higher in people with untreated coeliac disease.
Your tamaiti must be eating gluten for about 6 weeks before the test. During this time, they will need to eat a minimum of 2 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 general practice team will arrange for your tamaiti to have further tests. These can include:
- another blood test
- a sample (biopsy) taken from the small bowel.
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 need HLA testing. It can be useful if there is uncertainty about your child's diagnosis. The gene test alone cannot diagnose coeliac disease.
Sample from the small bowel (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 the small bowel.
Laboratory staff then examine the biopsies under a microscope. It can take a week or 2 to get the results.
Treating coeliac disease in children
The only treatment for coeliac disease is for your tamaiti 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.
Your tamaiti will need to remain on a gluten-free diet for life.
Your tamaiti should not be on a gluten-free diet unless testing has confirmed that they have coeliac disease. If your tamaiti does not have coeliac disease and you take gluten out of their diet, there is a risk of them developing an allergy to gluten-containing grains.
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.
HealthInfo recommends the following videos
- Listening to Families – Coeliac disease
A paediatric gastroenterologist and dietitians answer families' questions about coeliac disease in tamariki.
HealthInfo recommends the following pages
- Coeliac New Zealand
Information about coeliac disease and gluten-free eating.
- KidsHealth – Coeliac Disease
Extensive information about coeliac disease in tamariki.
On the next page: Helping your child live with coeliac disease
Adapted from KidsHealth as part of a National Health Content Hub collaborative. Last reviewed December 2024.
SourcesReview key: HICDC-16032
