Question:

My daughter, age 2, was diagnosed 3 months ago with celiac. Just recently we are having a huge issue with constipation. Do you have any suggestions?

From,

Holly

Answer:

Hi Holly. Thanks so much for your question. I’m sorry to hear your daughter has been having issues with constipation. I definitely have a few ideas that you can try with her to help alleviate things.

You don’t mention if your daughter had constipation before her diagnosis. Constipation may occur as a symptom of celiac disease, and should start to resolve after some time on a gluten-free diet as the GI tract and villi begin to heal.

Another, more common reason for constipation often occurs when first starting a gluten-free diet, and that is the removal of fiber-containing whole wheat from the diet.

While more and more “whole grain” gluten-free products are on the market these days, there are still many highly processed gluten-free products (i.e. crackers, pasta, breads) whose main ingredients are tapioca flour, potato starch, and/or white rice, all of which contain very little fiber.

Your best bet is to look for products containing fiber-rich gluten-free grains that are listed at the top of the ingredient list. These include amaranth, quinoa, buckwheat, millet, montina, sorghum and teff. In addition, fruits and vegetables, nuts, seeds, beans and legumes are excellent sources of fiber and should be a daily part of your daughter’s diet to help prevent constipation.

Additionally, it’s also important for your daughter to drink adequate liquids throughout the day to help alleviate constipation, especially when consuming a higher fiber diet. Water is best, but milk (cow’s or non-dairy alternative) and juice also count towards daily fluid requirements, and, again, the more fruits and veggies, the better, as they also are an excellent source of fluids.

If your daughter’s symptoms persist, despite adding more fiber and fluids to the diet, I recommend you check with her physician to see if there are any other medical causes contributing to her constipation. In addition, you may want to work with a registered dietitian who specializes in celiac disease and gluten sensitivity, to help provide you with a high fiber menu plan your daughter will enjoy eating.

In good health,

EA Stewart, MBA, RD

For more questions related to celiac disease and gluten sensitivity in children, visit Ask the Pediatric Gastroenterologist on NFCA’s Kids Central.