Gluten intolerance in children arising from wheat allergy, celiac disease, or non-celiac gluten sensitivity may be difficult to pin down. While there are some common symptoms indicating your child is gluten intolerant, there are others that are less common and therefore more difficult to connect to some form of gluten sensitivity.
The Children's Hospital of Philadelphia notes unexplained skin issues, such as rashes, eczema, and acne, may occur in children who have an undiagnosed gluten sensitivity when they are exposed to gluten. These skin eruptions commonly occur on the elbows, knees, back of the neck, or buttocks, but they may also appear elsewhere. If you note your child is having unexplained skin eruptions, talk to your doctor. It may be helpful to keep a diary that tracks what your child eats daily and when the skin eruptions occur in order to provide more concrete information so your doctor can make an accurate diagnosis.
Feeling like the mind is foggy and experiencing difficulty concentrating is a common symptom of gluten sensitivity or intolerance according to Healthline, and some studies show it may affect as many as 40 percent of adults and children with some form of gluten sensitivity. The Children's Hospital of Philadelphia states it is the most common symptom of gluten intolerance in kids, so if your child appears to have difficulty with concentration and says her head feels cloudy or she has trouble thinking, gluten may be the culprit.
Celiac disease causes damage to the villi (villous atrophy) in the small intestine which is where the body absorbs nutrients. Damage hampers nutrient absorption, so kids with undiagnosed gluten intolerance may be deficient in certain nutrients. The Gluten Intolerance Group notes iron-deficiency anemia may be a particular problem with gluten sensitivity because of poor iron absorption and supplementing with iron is unlikely to help this due to damage to the villi. Likewise, a July 2000 study in the American Journal of Clinical Nutrition (AJCN) noted celiac disease is the most common cause of malnutrition in children in Western countries.
Watch your child for symptoms of anemia, such as lethargy, exhaustion, pale skin, and easy bruising, and talk to your doctor about testing his blood if you suspect any nutrient deficiencies (malnutrition).
Unexplained Aches and Pains
Children with gluten intolerance may experience unexplained aches and pains, particularly headaches and joint pain. One study showed headaches were a common symptom in pediatric patients with gluten intolerance which was alleviated by gluten elimination. Likewise, Gluten Free Society lists joint pain as a primary symptom in people who have some sort of gluten intolerance. Since joint pain is an uncommon symptom in children, this may be easier to spot than some of the other symptoms, particularly if your child frequently complains of aches and pains without a specific onset.
The Celiac Disease Foundation lists several gastrointestinal symptoms in children that may occur as a result of celiac disease or gluten intolerance. These include:
- Abdominal pain and bloating
- Foul smelling bowel movements
- Chronic diarrhea
A child with gluten intolerance may also complain of pain when having a bowel movement or experience extreme urgency and pain immediately before a bowel movement.
Unexplained Weight Loss or Poor Weight Gain
Children who are sensitive or intolerant to gluten may also experience difficulty in gaining the appropriate amount of weight for their developmental stage (or they may be losing weight inexplicably) according to Cleveland Clinic. The July 2000 study in AJCN noted children with undiagnosed celiac disease displayed "remarkable abnormal body composition" which shifted quickly to a more normal composition when gluten was eliminated from the diet.
Mood or Behavior Issues
While research is ongoing, some experts link kids' mood and behavior issues to gluten intolerance. For example, a report in The Primary Care Companion for CNS Disorders noted co-occurrence of celiac disease and ADHD was "markedly over represented" and found a gluten-free diet helped with the ADHD symptoms in these cases.
Less Common Symptoms
There are many less common symptoms of gluten intolerance as well. For example, a report in Gastroenterology Research and Practice notes non-classic presentation of celiac disease and gluten intolerance is common and may include less recognizable symptoms such as:
- Short stature
- Impaired school learning and function
- Other behavior issues
- Impaired physical fitness
- Chronic fatigue
- Erosion of dental enamel
- Delayed onset of puberty
- Psychiatric disorders
When in Doubt
With such a broad array of symptoms of gluten intolerance, medical evaluation is necessary. Track your child's symptoms and food intake so you have more information to provide your doctor and ask your doctor to test your child for gluten sensitivity. Even if a diagnosis of gluten intolerance isn't present, you may also wish to work with your doctor to try a gluten elimination diet for your child to see if he or she experiences improvement in symptoms.