Pediatric Digestive Diseases

Pediatrics

Celiac Disease

What is Celiac Disease?

Celiac disease an autoimmune disorder that causes people to develop an inflammation of the small intestine when they eat gluten, which is found in certain grains including wheat, rye and barley. This inflammation can progress and damage the villi, the small fingerlike structures lining the intestine which absorb nutrients. Such damage can prevent children from effectively absorbing nutrients from food, which can result in malnutrition and impact growth and development.

Celiac disease can develop at any age, from infancy to late in life. Some people have no trouble eating gluten for many years and then suddenly develop an immune response.

Signs & Symptoms of Celiac Disease

Gastrointestinal symptoms:

  • Abdominal pain
  • Poor weight gain
  • Vomiting
  • Diarrhea
  • Constipation
  • Mouth sores
  • Bloating

Non-gastrointestinal symptoms:

  • Low energy/fatigue
  • Joint pain
  • Change in behavior
  • Poor height velocity
  • Lactose intolerance and vitamin and mineral deficiencies, including iron deficiency anemia

Some children are asymptomatic but require screening due to an underlying predisposition. These include those with:

  • First degree relatives with celiac disease
  • Type 1 diabetes
  • Trisomy 21
  • William Syndrome
  • Turner Syndrome

How We Diagnose Celiac Disease

Screening Blood Test

The first step in the diagnosis of celiac disease is a screening blood test to evaluate for elevated levels of celiac antibodies, called titers. The most common celiac antibody is called tissue transglutaminase (TTG). Additionally, we can draw blood to determine if your child has one of the two genes necessary to develop celiac disease. These are called human leukocyte antigens (HLA-DQ2 and HLA-DQ8). It is important that children with a first-degree relative (parent or sibling) with celiac disease undergo screening, as their risk for developing celiac is 10%. The risk in the general population is 1%.

Upper Endoscopy

If your child has an elevated TTG level, the next step is confirmation with an upper endoscopy conducted by your pediatric gastroenterologist. During an endoscopy, a flexible tube (camera) is used to visualize the entire upper digestive tract and tissue samples (biopsies) are taken from the small intestine. Endoscopy is considered the gold standard to confirm a diagnosis of celiac disease.

Testing for celiac disease requires the presence of gluten in the child’s diet, so please do not eliminate gluten until testing is complete and a diagnosis is made.

Contact us


NewYork-Presbyterian Morgan Stanley Children's Hospital

NewYork-Presbyterian Komansky Children's Hospital