Coeliac disease in children

What you need to know

• Consider coeliac disease in children with both classic gastrointestinal symptoms (variable bowel habit, abdominal pain) and non-classic presentations (such as impaired growth, tiredness, anaemia)

• Have a low threshold for investigation of symptomatic children and screening for those with associated conditions such as type 1 diabetes or Down’s syndrome

• Initial testing is by serology (total IgA and IgA anti-tTG), and inform parents not to exclude gluten from their children's diet before testing

Sources and selection criteria

In creating this article, we initially reviewed the BSPGHAN and ESPGHAN guidance, which formed the basis of the article.

We reviewed articles referred to within the guidance and conducted a PubMed search of papers published after 2000 using the search terms “celiac disease” and “children.” We also reviewed relevant additional references from papers obtained. We then added our personal archives of references to obtain a generalised overview of coeliac disease and issues specific to children. For more specific elements—such as the association of coeliac disease with menses and fertility—we performed specific PubMed searches in order to obtain more recent references.

The article was formatted as per the BMJ guidance, and clinical experience plus evidence collected were used to ensure that common issues which arise within paediatric coeliac disease were addressed.