Celiac Disease in Children

Advanced Diagnosis and Treatment for an Active Childhood

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Duke pediatric gastroenterologists and dieticians diagnose and treat your child’s celiac disease. We partner with you to create a gluten-free diet for your child and provide long-term follow-up care so your child maintains a healthy and active life.

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About Celiac Disease

Celiac disease occurs when the body cannot digest or break down gluten-containing products that are found in wheat, barley and rye. For example, products like bread, crackers, and cookies contain significant amount of gluten. Eating gluten makes the body’s immune system go on the attack and create toxins. This abnormal, autoimmune response damages the finger-like villi in the small intestines that absorb nutrients from food. If left untreated, celiac disease can lead to malnutrition and other complications. 

Celiac disease is more common than many people realize. In fact, it is one of the most common autoimmune conditions in children. It affects approximately 1 in 144 people in the western countries and the numbers are higher in certain geographic locations based on genetic and other environmental factors. Celiac disease is still largely underdiagnosed due to the varied presentation of clinical signs and symptoms.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Diagnostic Tests

Celiac disease is difficult to diagnose. In some people, gluten causes a mild sensitivity. In others, gluten kicks off an autoimmune response. Our celiac disease experts meet with you and your child to determine what the cause of his/her symptoms and to make a diagnosis.

Family History

Your doctor will talk with you about your child’s medical history. Children with another autoimmune or genetic disorder, such as diabetes or a thyroid problem, are at risk for celiac disease. A family history of celiac disease increases the chance of diagnosis.

Physical Exam

Your doctor will perform a physical exam to check your child’s health, including weight and developmental stage. The chronic fatigue, diarrhea and malnutrition of celiac disease can slow a child’s growth. The doctor may also check your child’s skin for signs of an itchy skin rash on their bottom, elbows or knees.

Blood Tests

A blood sample checks for certain antibodies that can signal celiac disease.


A small flexible tube with a camera at the end allows your child’s doctor to view the inside the small intestine. This test lets the doctor check the villi for any damage and take small tissue samples to check under a microscope for signs of celiac disease.

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Gluten-Free Diet

While there is no cure for celiac disease, a gluten-free diet will stop your child's body from making the toxins that harm the small intestine. Our specialty-trained dietitian creates a meal plan for your child and teaches you how to read food labels to avoid ingredients that contain gluten. We help your child maintain a gluten-free diet while ensuring they get the nutrition needed to develop and grow.

Nutritional Supplements

Your child’s doctor may prescribe vitamins (such as vitamin D) and other nutritional supplements (such as iron) to ensure your child gets the proper nutrients and to avoid complications, such as fatigue and bone fractures.

Follow-Up Care

Your child will be seen by our celiac disease experts frequently during the first year of diagnosis, and annually after. We answer questions, provide information on new gluten-free foods, and check your child’s growth, development and nutrition levels. We coordinate your child’s care with your local doctor and monitor for any changes.

Best Children's Hospital in NC

Duke Children's Hospital & Health Center is proud to be nationally ranked in 10 pediatric specialties.

Why Choose Duke

Access to Clinical Trials
New medicines for celiac disease are being studied. If appropriate, your child may be able to try an investigational medicine as part of a clinical trial. Be sure to talk with your doctor about this possibility. 

A Team Approach
If your child has another autoimmune or genetic disorder, our pediatric celiac disease experts collaborate with other specialists to ensure that your child receives the best care possible.

Family Support
Families who come to Duke for pediatric celiac disease care may have opportunities to share experiences and learn about the latest advances in celiac disease treatments.