Paediatrics

Presentation

Coeliac disease is a common disorder in children as well as in adults. It presents with a wide range of manifestations, the variation of which is not fully understood. The "typical" child presents following weaning between 6 and 24 months with impaired growth, abnormal stools, abdominal distention, muscle wasting, a poor appetite and unhappy behaviour. Stools become pale, frequent and bulky. Constipation and diarrhoea may be seen and may alternate, and vomiting may also occur.

Atypical symptoms may also be seen, such as dental enamel defects, recurrent mouth ulcers and muscle pain and stiffness.  

Currently extraintestinal manifestations (such as anaemia and short stature) are more common than the classic malabsorption symptoms (1) so healthcare professionals need to be aware of this to ensure early diagnosis.

There is a specific diagnostic procedure that should be followed for any child presenting with symptoms who is suspected of having coeliac disease.

References

1 Fasano A. Coeliac presentation in children. Gastroenterology 2005;128:S68-73