Managing children with coeliac disease in the community

Abstract

Coeliac disease is an autoimmune condition caused by sensitivity to gluten-containing foods. It affects around 1% of children, although many cases may remain undiagnosed. Health visitors should be aware of the classic gastrointestinal features of coeliac disease and make an early referral to medical professionals. Breastfeeding is considered to have a protective role. Suspicion of coeliac disease should lead to antibody screening tests and the diagnosis is confirmed by an intestinal biopsy. A gluten-free diet (GFD) should always be started by paediatric dietitians, but health visitors can play an important role in educating and supporting families. Extra-intestinal manifestations (e.g. severe iron-deficiency anaemia or short stature) can pose a diagnostic challenge, and a suspicion of coeliac disease should always be discussed with a medical professional. Strict adherence to a GFD is essential to maintain good health and to prevent development of long-term complications.