Diagnosis and nursing management of coeliac disease in children
Siba Prosad Paul Specialty trainee, year 8, paediatrics, Yeovil District Hospital NHS Foundation Trust, Bristol Royal Hospital for Children
Lauren McVeigh Specialist paediatric dietitian, Bristol Royal Hospital for Children
Elena Gil-Zaragozano Clinical nurse specialist in paediatric gastroenterology, Bristol Royal Hospital for Children
Dharamveer Basude Consultant paediatric gastroenterologist, Bristol Royal Hospital for Children
Siba Prosad Paul and colleagues discuss the importance of spotting coeliac disease promptly and supporting children who need to follow a gluten-free diet
Coeliac disease is an autoimmune condition caused by the ingestion of gluten-containing foods and affects about 1% of children and young people in the UK. Classic symptoms include diarrhoea, bloating, weight loss and abdominal pain. However, extra-intestinal manifestations, such as iron deficiency anaemia, faltering growth, delayed puberty and mouth ulcers, are increasingly being recognised. Some children have an increased risk of developing coeliac disease, such as a strong family history, certain genetic conditions and type 1 diabetes, therefore there is a need for increased awareness and early diagnosis before symptoms occur.
If coeliac disease is suspected, a child should have serological screening with anti-tissue transglutaminase titres. Diagnosis is traditionally confirmed by a small bowel biopsy while the child remains on a ‘normal’ diet that does not exclude gluten. More recently, for a selective group of children, modification of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition guidelines has enabled non-biopsy (serological) diagnosis of coeliac disease.
Children’s nurses have an important role in recognising and diagnosing coeliac disease earlier as well as offering ongoing dietary support. Enabling children to maintain a gluten-free diet is essential for general wellbeing and preventing long-term complications.
Nursing Children and Young People. 28, 1,18-24. doi: 10.7748/ncyp.28.1.18.s28Correspondence
This article has been subject to open peer review and has been checked using antiplagiarism softwareConflict of interest
Received: 25 June 2015
Accepted: 24 September 2015