Are coeliac disease and gluten allergy the same in children?

"Gluten allergy" is a popular term that in most cases means coeliac disease. However, coeliac disease is not an allergy in the traditional sense, but an autoimmune disease. In children, coeliac disease must also be distinguished from food allergy and food intolerance, which cause similar symptoms.

What are the first signs of coeliac disease in children?

In infants and young children, early signs are often poor well-being, weight gain problems, bloating and loose, foul-smelling stools. In older children, reduced growth, abdominal pain and fatigue are often seen. However, many children have only mild or no obvious symptoms.

How many children have coeliac disease?

Coeliac disease occurs in about 0.5% of the Danish population, corresponding to approximately 1 in 200 people, and the disease can occur as early as the first years of life. Many children are not diagnosed, as the symptoms are often mild or nonspecific.

How are children tested for coeliac disease?

The investigation begins with blood tests that measure antibodies against transglutaminase. If the blood tests suggest coeliac disease, the diagnosis is typically confirmed with a tissue sample from the small intestine taken during a colonoscopy.

Is coeliac disease hereditary?

Yes, coeliac disease is strongly hereditary. Almost everyone with celiac disease has certain tissue types (HLA-DQ2 or HLA-DQ8), and if the child has a close relative with the disease, they themselves have an increased risk of developing it.

What should a child with coeliac disease not eat?

The child should avoid all products containing gluten from wheat, rye and barley. Most children with coeliac disease can tolerate certified gluten-free oats, but regular oats may be contaminated with gluten from other grains.

Can children grow out of coeliac disease?

No, celiac disease is a lifelong condition that children do not outgrow. However, with a consistent gluten-free diet, children with celiac disease can have normal growth and development and live completely symptom-free.

What happens if coeliac disease in children is not treated?

Untreated coeliac disease can over time lead to deficiencies such as iron, calcium and vitamin deficiencies and affect the child's growth. With a gluten-free diet, the condition normalizes in the vast majority of people, which emphasizes the importance of early diagnosis.

Hvad er cøliaki hos børn?

Cøliaki er en kronisk autoimmun sygdom, hvor indtagelse af gluten skader tyndtarmens slimhinde og forhindrer kroppen i at optage næringsstoffer korrekt. Hos børn kan det vise sig som dårlig trivsel, nedsat vækst eller mave-tarmsymptomer, og sygdommen behandles med en livslang glutenfri kost.

Er cøliaki og glutenallergi det samme hos børn?

Glutenallergi er en folkelig betegnelse, som i de fleste tilfælde betyder cøliaki. Cøliaki er dog ikke en allergi i traditionel forstand, men en autoimmun sygdom. Hos børn skal cøliaki desuden skelnes fra fødevareallergi og fødevareintolerance, som giver lignende symptomer.

Hvad er de første tegn på cøliaki hos børn?

Hos spædbørn og mindre børn er tidlige tegn ofte dårlig trivsel, vægtøgningsproblemer, oppustet mave og løs, ildelugtende afføring. Hos større børn ses ofte nedsat vækst, mavesmerter og træthed. Mange børn har dog kun milde eller ingen tydelige symptomer.

Hvor mange børn har cøliaki?

Cøliaki forekommer hos omkring 0,5 % af den danske befolkning, svarende til cirka 1 ud af 200 personer, og sygdommen kan opstå allerede i de første leveår. Mange børn er ikke diagnosticeret, da symptomerne ofte er milde eller uspecifikke.

Kan dårlig vækst hos mit barn skyldes cøliaki?

Ja, nedsat højdevækst og dårlig trivsel er nogle af de mest almindelige tegn på cøliaki hos børn, fordi tarmen ikke kan optage næringsstofferne fra maden korrekt. Hvis et barn ikke følger sin forventede vækstkurve uden anden forklaring, vil lægen typisk undersøge for cøliaki som en del af udredningen.

Hvordan testes børn for cøliaki?

Udredningen starter med blodprøver, hvor man måler antistoffer mod transglutaminase. Hvis blodprøverne giver mistanke om cøliaki, bekræftes diagnosen typisk med en vævsprøve fra tyndtarmen taget ved en kikkertundersøgelse.

Er cøliaki arveligt?

Ja, cøliaki er stærkt arveligt betinget. Næsten alle med cøliaki har bestemte vævstyper (HLA-DQ2 eller HLA-DQ8), og har barnet en nær slægtning med sygdommen, har det selv en øget risiko for at udvikle den.

Hvad må et barn med cøliaki ikke spise?

Barnet skal undgå alle produkter, der indeholder gluten fra hvede, rug og byg. De fleste børn med cøliaki kan tåle certificeret glutenfri havre, men almindelig havre kan være forurenet med gluten fra andre kornsorter.

Kan børn vokse fra cøliaki?

Nej, cøliaki er en livslang tilstand, som børn ikke vokser fra. Med en konsekvent glutenfri kost kan børn med cøliaki dog have normal vækst og udvikling og leve helt symptomfrit.

Hvad sker der, hvis cøliaki hos børn ikke bliver behandlet?

Ubehandlet cøliaki kan over tid medføre mangeltilstande som jern-, kalk- og vitaminmangel samt påvirke barnets vækst. Med en glutenfri kost normaliseres tilstanden hos langt de fleste, hvilket understreger vigtigheden af, at diagnosen stilles tidligt.

Coeliac disease in children

Coeliac disease is one of the most common chronic diseases in the Western world. According to the Danish Paediatric Society, the prevalence in Denmark is estimated at around 1%, but a large proportion are undiagnosed because many have mild or no symptoms.

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Coeliac disease, also known as gluten intolerance, is a chronic autoimmune condition in which consuming gluten damages the lining of the small intestine and prevents the body from absorbing nutrients properly. In children, the condition may cause failure to thrive, impaired growth or gastrointestinal symptoms such as diarrhoea and abdominal pain. However, some children experience only mild symptoms or show no obvious signs at all. Coeliac disease is not contagious and is neither an allergy nor a dietary preference, but a lifelong condition treated with a gluten-free diet.

Coeliac disease is one of the most common chronic conditions in the Western world and affects approximately 1 in 200 people in Denmark, equivalent to around 0.5% of the population. The condition can develop during the first years of life when a child begins eating foods containing gluten, but symptoms may also appear later in childhood.

Are Gluten Allergy and Coeliac Disease in Children the Same Thing?

"Gluten allergy" is an informal term that, in most cases, refers to coeliac disease. It is not an official medical diagnosis. Coeliac disease is an autoimmune condition in which the immune system attacks the intestinal lining when gluten is consumed.

Children may also develop food allergies (such as wheat allergy) or food intolerances, which can cause many of the same symptoms as coeliac disease but are different conditions with different underlying causes and treatments. Only a doctor can determine which condition is responsible.

What Are the Symptoms of Coeliac Disease in Children?

The symptoms of coeliac disease in children vary considerably and often depend on age.

In infants and younger children, common signs include failure to thrive, difficulty gaining weight or actual weight loss, as well as frequent, loose and foul-smelling stools. Children may appear irritable and have a bloated, distended abdomen.

In older children, reduced height growth and generally impaired growth are often the main reasons for suspecting coeliac disease, frequently accompanied by abdominal pain, excessive gas and fatigue. Unexplained iron deficiency is also a common finding.

However, some children experience only mild or non-specific symptoms, while others have no symptoms at all. In these cases, coeliac disease is often discovered through a blood test performed for another reason or because the child is not following their expected growth curve.

Could My Child's Poor Growth Be Caused by Coeliac Disease?

Yes. Reduced height growth and failure to thrive are among the most common signs of coeliac disease in children because the intestine cannot properly absorb nutrients from food.

If a child is not following their expected growth curve and there is no other clear explanation, coeliac disease is one of the conditions a doctor will typically investigate using a blood test.

Causes of Coeliac Disease in Children

Coeliac disease develops when the immune system reacts abnormally to gluten, a protein found in wheat, rye and barley. This reaction damages the intestinal villi, the small finger-like projections in the small intestine that are normally responsible for absorbing nutrients from food.

The condition has a strong genetic component. Almost everyone with coeliac disease carries certain genetic markers, known as HLA-DQ2 or HLA-DQ8, which are present from birth and are associated with the development of the disease.

However, coeliac disease only develops after gluten has been introduced into the child's diet. If a close relative has coeliac disease, the child has an increased risk and should be tested for relevant antibodies if symptoms develop.

How Is Coeliac Disease Diagnosed in Children?

When coeliac disease is suspected, the initial assessment involves blood tests to measure antibodies against tissue transglutaminase (TG2). These antibodies are elevated in the vast majority of children with active coeliac disease.

If the blood tests suggest coeliac disease, a tissue sample (biopsy) from the lining of the small intestine, obtained during an endoscopic examination (gastroscopy), can confirm the diagnosis. The doctor will always assess whether a gastroscopy is necessary in each individual case. If appropriate, we refer the child to a specialised department that can perform the examination.

It is important that the child continues eating foods containing gluten until the diagnostic process is complete. Otherwise, both blood tests and any potential biopsy may produce normal results even if the child has coeliac disease.

Treatment of Coeliac Disease in Children

Coeliac disease cannot be cured, but it can be managed very effectively with a lifelong, completely gluten-free diet.

When gluten is entirely removed from the diet, the intestinal lining can heal. In the vast majority of children, the condition improves significantly, with appetite, weight and growth often returning to normal and symptoms disappearing.

A gluten-free diet means avoiding all products containing wheat, rye and barley. Most children can tolerate certified gluten-free oats.

At the beginning of treatment, some children may need iron or other mineral supplements if they have developed nutritional deficiencies.

Can Children Outgrow Coeliac Disease?

Coeliac disease is a lifelong condition that children do not outgrow.

However, with a consistently gluten-free diet, children with coeliac disease can grow and develop normally and live completely free of symptoms.

This requires maintaining a strictly gluten-free diet throughout life. Even small amounts of gluten can damage the intestine again over time, even if the child does not experience immediate symptoms.

Complications of Untreated Coeliac Disease in Children

If coeliac disease in children is left untreated, it can lead to complications over time.

The most common complications include nutritional deficiencies, such as iron, calcium and vitamin deficiencies, which can cause anaemia and, in the longer term, osteoporosis.

Persistent untreated coeliac disease can also affect a child's growth if the condition is not addressed in time.

It is therefore important to establish the diagnosis early and monitor the child regularly afterwards to ensure that their diet and growth are progressing as expected.

When Should You Seek Medical Advice?

It may be appropriate to contact your doctor if your child is not growing or gaining weight as expected, experiences recurring abdominal pain, changes in bowel habits, unexplained fatigue or iron deficiency without another clear cause.

If a close family member has coeliac disease, a blood test may also be appropriate, even if your child's symptoms are mild.

Coeliac Disease in Children at Charlottenlund Privathospital

The diagnostic assessment focuses on the child's symptoms and growth and may include relevant blood tests and referrals for further examinations where necessary.

The examining doctor will always discuss the findings with you and determine the most appropriate next steps together.

If you are unsure whether your child's symptoms could be caused by coeliac disease, you are welcome to book an appointment online or contact us for more information.

Experience and Expertise at Charlottenlund Privathospital

At Charlottenlund Privathospital, children with suspected coeliac disease are assessed by specialists in paediatrics.

The diagnostic process is based on the child's symptoms and growth, supplemented by relevant blood tests (antibodies against tissue transglutaminase). Children are referred for a tissue sample (biopsy) when considered necessary.

You can find an overview of all departments on our departments page.

Sources:

Danish Paediatric Society: Coeliac Disease – Clinical Care Pathway (2022).
Ugeskrift for Læger (Danish Medical Journal): Diagnostic Challenges in Coeliac Disease

Frequently Asked Questions

What is coeliac disease in children?
Coeliac disease is a chronic autoimmune disease in which the ingestion of gluten damages the lining of the small intestine and prevents the body from absorbing nutrients properly. In children, it can manifest as poor well-being, reduced growth or gastrointestinal symptoms, and the disease is treated with a lifelong gluten-free diet.
Are coeliac disease and gluten allergy the same in children?
"Gluten allergy" is a popular term that in most cases means coeliac disease. However, coeliac disease is not an allergy in the traditional sense, but an autoimmune disease. In children, coeliac disease must also be distinguished from food allergy and food intolerance, which cause similar symptoms.
What are the first signs of coeliac disease in children?
In infants and young children, early signs are often poor well-being, weight gain problems, bloating and loose, foul-smelling stools. In older children, reduced growth, abdominal pain and fatigue are often seen. However, many children have only mild or no obvious symptoms.
How many children have coeliac disease?
Coeliac disease occurs in about 0.5% of the Danish population, corresponding to approximately 1 in 200 people, and the disease can occur as early as the first years of life. Many children are not diagnosed, as the symptoms are often mild or nonspecific.
Could poor growth in my child be due to celiac disease?
Yes, stunted growth and poor well-being are some of the most common signs of coeliac disease in children, because the intestines cannot properly absorb nutrients from food. If a child is not following their expected growth curve without another explanation, the doctor will typically test for celiac disease as part of the evaluation.
How are children tested for coeliac disease?
The investigation begins with blood tests that measure antibodies against transglutaminase. If the blood tests suggest coeliac disease, the diagnosis is typically confirmed with a tissue sample from the small intestine taken during a colonoscopy.
Is coeliac disease hereditary?
Yes, coeliac disease is strongly hereditary. Almost everyone with celiac disease has certain tissue types (HLA-DQ2 or HLA-DQ8), and if the child has a close relative with the disease, they themselves have an increased risk of developing it.
What should a child with coeliac disease not eat?
The child should avoid all products containing gluten from wheat, rye and barley. Most children with coeliac disease can tolerate certified gluten-free oats, but regular oats may be contaminated with gluten from other grains.
Can children grow out of coeliac disease?
No, celiac disease is a lifelong condition that children do not outgrow. However, with a consistent gluten-free diet, children with celiac disease can have normal growth and development and live completely symptom-free.
What happens if coeliac disease in children is not treated?
Untreated coeliac disease can over time lead to deficiencies such as iron, calcium and vitamin deficiencies and affect the child's growth. With a gluten-free diet, the condition normalizes in the vast majority of people, which emphasizes the importance of early diagnosis.

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