Learn the facts about celiac disease

The only known treatment for celiac disease is a lifelong, strict, gluten-free diet. Fresh fruits and vegetables are naturally gluten-free.

Dr. Kevin Watson, an Akron Children’s pediatric gastroenterologist, has dedicated his professional life to caring for kids with conditions like celiac disease. He’s here to answer common questions and help you make informed decisions about your child’s health.

What is celiac disease?

It’s an immune condition trigged by gluten – a protein in wheat, barley and rye. When people have celiac disease, their immune system reacts to gluten by attacking the lining of the gastrointestinal (GI) tract. This is a tube that food and liquids travel through as they are digested, absorbed and turned into waste that exits the body.

Left untreated, the damaged lining can cause everything from malnutrition to delayed growth to nerve and bone damage.

What are the symptoms?

I call celiac disease “the great pretender” because it can present in many ways. Symptoms include stomach pain, ongoing diarrhea or constipation, throwing up or growth issues. Other signs can include joint pain, feeling very tired or cranky and having trouble focusing.

When are people usually diagnosed?

We don’t see celiac disease in babies because they’re not exposed to gluten yet. We most often diagnose adolescents. But symptoms can develop earlier, depending on the gluten exposure kids have. It can also present in people in their 40s and 50s.

How is celiac disease diagnosed?

We typically do a blood test called a “tissue transglutaminase.” If that comes back elevated, an upper endoscopy procedure helps us officially diagnose a patient.

Is celiac disease inherited?

Yes, it runs in families. A genetic test can determine if your child has a genetic risk for celiac disease. Upwards of 95% of people who have celiac disease have a specific gene marker (HLA-DQ2 or HLA-DQ8).

Dr. Kevin Watson

Why does it seem like celiac disease is more common than decades ago?

People are much more aware of it today. Earlier generations might have had symptoms they attributed to a “sensitive stomach,” and they just lived with it.

What treatment helps people manage their condition?

The only known treatment is a lifelong, strict, gluten-free diet. That can be hard, especially if you’re dealing with a young child.

Celiac disease isn’t an allergy, but that’s how I explain it because people understand the concept. The patient must eliminate all exposure to gluten because of the potential long-term risks.

What foods can someone with celiac disease eat?

Fresh fruits, vegetables and meats are naturally gluten-free. More gluten-free snacks and pantry staples are available than ever before. But look out for hidden gluten in processed meats and any type of sauce because flour is often used for thickening.

My child is newly diagnosed. What changes can we make at home?

Some families go gluten-free in the house. If you don’t, that’s OK. You can reduce the risk of cross contamination by making a gluten-free area in the pantry and refrigerator. Also, have a separate toaster and storage containers for gluten-free foods. Clean your utensils and cookware thoroughly, or have separate items for gluten-free cooking.

If your child has celiac disease, it’s important to work with the principal, 504 plan coordinator or guidance counselor to ensure proper accommodations are in place.

How can I protect my child at school?

Have a 504 plan to ensure your child gets the dietary and safety accommodations they need. If your child is newly diagnosed with celiac disease, contact the school’s principal, guidance counselor or 504 plan coordinator to start the conversation.

Will my child’s GI tract damage improve in time?

A gluten-free diet allows the GI tract to repair itself, and it often takes up to a year. To look for improvement, we repeat the tissue transglutaminase blood test. We also ask if your child still has belly pain, bloating or other symptoms. Patients often feel so much better after going gluten-free that they don’t want any exposure to gluten.

Another scenario is a child who goes gluten-free and then gets exposed to gluten. Their symptoms may be worse than before diagnosis. They feel rotten and don’t want to have gluten again. Plus, they risk more damage to the GI tract.

Are gluten intolerance and celiac disease the same thing?

No. A child can have an upset stomach and bloating after eating gluten, but it’s not celiac disease. In that situation, they may just reduce the amount of gluten they eat. But they’re not hurting the GI tract like someone who has celiac disease.

If I suspect an issue with my child, what should I do?

Start with your child’s primary care provider, who can talk about your child’s symptoms and do the blood test. If it’s positive, see a pediatric gastroenterologist. Do not have your child go gluten-free until a confirmed celiac disease diagnosis because reducing gluten can skew the test results.

How long should I wait to take my child to the doctor?

If your child has “red flag” symptoms like weight loss or growth issues, do not wait to get them to the doctor. If your child has a belly ache here and there, it’s fine to wait and see if symptoms continue.