Celiac Disease

What Is Celiac Disease?

Celiac disease occurs when the immune system reacts abnormally to gluten—a protein found in wheat, barley, and rye. This immune reaction damages the lining of the small intestine, impairing nutrient absorption and causing a wide range of symptoms.

Who Is at Risk?

Celiac disease can occur at any age once gluten is introduced into the diet. Children with a family history of celiac disease or related autoimmune conditions (like type 1 diabetes or thyroid disease) are at higher risk. It's also more common in children with genetic syndromes such as Down syndrome or Turner syndrome.

Common Symptoms in Children

Symptoms can vary widely, making diagnosis challenging. Some children show classic gastrointestinal symptoms, while others present with more subtle signs. Common symptoms include:

• Chronic diarrhea or constipation
• Abdominal bloating and pain
• Poor weight gain or weight loss
• Fatigue or irritability
• Delayed growth and puberty
• Anemia (often iron-deficiency and unresponsive to iron therapy)
• Dental enamel defects
• Skin rashes (particularly dermatitis herpetiformis)

In some cases, children may be asymptomatic but still at risk for intestinal damage.

How Is It Diagnosed?

Diagnosis typically involves:

1. Blood tests: The most common is the tissue transglutaminase antibody (tTG-IgA) test. Other tests may be used in younger children or those with IgA deficiency.
2. Endoscopy with biopsy: If blood tests suggest celiac disease, a gastroenterologist will perform an upper endoscopy to examine and biopsy the small intestine lining to confirm the diagnosis.

Important: Children must be eating gluten regularly before testing. Do not start a gluten-free diet before speaking with a healthcare provider.

Treatment

There is no cure for celiac disease, but it can be managed effectively with a strict lifelong gluten-free diet. This means avoiding all foods and products containing wheat, barley, and rye.

A registered dietitian specializing in celiac disease can help families navigate food choices and label reading. With proper adherence to the diet, most children see symptom improvement within weeks and experience normal growth and development.

Monitoring and Long-Term Care

Children with celiac disease require regular follow-ups to:

• Monitor growth and nutritional status
• Check for adherence to the gluten-free diet
• Screen for associated conditions (e.g., thyroid disease, nutritional deficiencies)
• Provide psychosocial support, especially around school and social eating

Supporting Families

Living gluten-free can be a major lifestyle adjustment for families. Pediatricians and care teams play a key role in educating, supporting, and connecting families with resources such as:

• Celiac disease foundations
• Local support groups
• Gluten-free nutrition counseling
• School accommodations (504 Plans)

We’re Here to Help
If your baby develops a fever, don’t panic—you’re not alone. Sima Stein, MD clinic is here to guide you through every stage of your child’s health. Contact our office anytime you have concerns about your infant's temperature, feeding, or behavior.

Need care now?
Schedule an appointment with Dr. Sima Stein, MD (San Jose) here: Book Online with Dr. Stein yelp.com+11doctor-stein.com+11doctor-stein.com+11