Celiac disease is an immune reaction to gluten that damages the small intestine. It can cause gut symptoms — but it can also show up as growth issues, anemia, or fatigue.
Common symptoms (and many kids have subtle symptoms)
Toddlers/young children
- Poor weight gain or slowed growth
- Chronic diarrhea or bulky stools (sometimes constipation instead)
- Bloating, belly pain
- Irritability
School age / teens
- Abdominal pain, nausea
- Fatigue, headaches
- Constipation or diarrhea
- Iron-deficiency anemia
- Short stature or delayed puberty
Who should be tested (higher risk groups)
- First-degree relative with celiac disease
- Type 1 diabetes
- Autoimmune thyroid disease
- Down syndrome
- Unexplained iron deficiency, poor growth, chronic GI symptoms
The most important rule
Do not start a gluten-free diet before testing. If gluten is removed, blood tests can become falsely negative.
How testing usually works
- Blood tests (including celiac antibodies) while still eating gluten
- If positive (or if high suspicion), referral for confirmation pathway (often includes endoscopy depending on context and local protocols)
If diagnosed: what changes
- Strict gluten-free diet (education is essential)
- Monitoring growth and nutrient status
- Family education on cross-contamination
When to seek urgent assessment
- Significant weight loss, dehydration, persistent vomiting
- Severe symptoms or child looks unwell