Aoife Hearne: Has my child inherited coeliac disease from her grandad?

My five-year-old has complains about a sore tummy after eating toast or a sandwich

My father is a coeliac and I’m worried my daughter may have the same condition. She’s five and has recently started complaining about a sore tummy, particularly after eating toast or a sandwich. Should I eliminate all gluten products from her diet? Or does she need to be tested?

Gut issues are common. Almost half of the people who make appointments to see me have some form of gut complaint, ranging from mild bloating to irritable bowel syndrome.

Irritable bowel syndrome (IBS) is the most common gut complaint, and, according to the Irish Medical Journal, it affects between 10% and 20% of the Irish population. IBS symptoms include bloating, cramping and pain, diarrhoea, and constipation. While these symptoms can be debilitating for people with IBS, they are generally not life-threatening. Treatment usually involves looking at current eating habits and may include the low FODMAP diet, which helps identify foods that trigger symptoms and should be reduced or avoided.

Unlike some other gut complaints, however, coeliac disease is an autoimmune condition that is triggered by an abnormal response to gluten. While coeliac disease has many symptoms in common with IBS, people often also experience anxiety, depression, tiredness, brain fog, and inability to focus.

Diagnosis and treatment of coeliac disease are also markedly different from IBS and there are serious long-term consequences of undiagnosed coeliac disease, such as iron-deficiency anaemia, osteoporosis, and fertility issues.

The incidence of coeliac disease is rising around the world. While it is estimated that one in every 100 people in Ireland has the disease, many experts believe the true prevalence is higher. In Finland, the rate is 2.5%, and it is also rising in China and India. Recent results from the SIGENP multi-centre screening study in Italy suggest that 60% of people with coeliac disease remain undiagnosed.

First- and second-degree relatives of people with coeliac disease are at increased risk, so familial screening is advised.

Screening for coeliac disease involves a blood test that measures tissue transglutaminase (tTg) and endomysial antibody (EMA) levels.

These are produced in response to eating gluten-containing foods, such as bread, pasta, pastries, cakes, breakfast cereals, biscuits, and anything made with flour. For this reason, and although it may be challenging, it is essential that your daughter continues to eat gluten until she has been screened.

My advice is to consult your GP and discuss the issues your daughter is experiencing, as well as her family history. Although this blood test may rule out coeliac disease, screening is still important.

A CORU-registered dietitian will also be able to offer evidence-based nutrition support, both before and after screening.

If you have a question for dietitian Aoife Hearne, please send it to [e-mail]