title: Diagnosis and nursing management of coeliac disease in children.
abstract: 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.
authors: Bristol Royal Hospital for Children.
authors: Siba Prosad
authors: SP
authors: Paul
authors: Bristol Royal Hospital for Children.
authors: Lauren
authors: L
authors: McVeigh
authors: Bristol Royal Hospital for Children.
authors: Elena
authors: E
authors: Gil-Zaragozano
authors: Bristol Royal Hospital for Children.
authors: Dharamveer
authors: D
authors: Basude
mesh_terms: D001323:Autoantibodies / Q000276:immunology; D002446:Celiac Disease / Q000175:diagnosis / Q000178:diet therapy / Q000451:nursing*; D002648:Child; D055050:Diet, Gluten-Free; D019204:GTP-Binding Proteins / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D007421:Intestine, Small / Q000473:pathology; D024802:Nurse's Role; D010371:Pediatric Nursing; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases / Q000276:immunology
chemical_list: D001323:Autoantibodies; D007070:Immunoglobulin A; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins
keywords: European Society for Paediatric Gastroenterology; Hepatology and Nutrition; child health; coeliac disease; gluten-free diet; paediatrics; serological diagnosis