Paediatrics

Presentation

Children with coeliac diseaseA condition where a person is unable to eat gluten as it makes their body attack itself. can present with a wide range of symptoms and signs. Symptoms develop following weaning and the introduction of foods that contain glutenA protein that is found in the cereals wheat, barley and rye. at between six months and two years of age.

The ‘’typical’’ child presents with:

• loss of appetite
• failure to thrive
• unhappy / clingy behaviour
• abnormal stools
• abdominal distension
• small stature
• muscle wasting.

In children with coeliac disease stools become pale, frequent and bulky. Constipation and diarrhoea may be seen and can alternate, and vomiting may also occur.

Atypical symptoms may also be seen and include:

• dental enamel defects
• recurrent mouth ulcers
• muscle pain and stiffness.  

Symptoms such as anaemia and short stature are often more common than the typical malabsorption symptoms (1) associated with coeliac disease. It is therefore important that children are carefully monitored to ensure early diagnosis.

There is a specific diagnostic procedure which should be followed for any child who is suspected of having coeliac disease. 

References

1. Fasano A (2005) Clinical presentation of coeliac disease in the paediatric population. Gastroenterology 128:S68-73