Joseph Murray, M.D., discusses a recent paper published in Pediatrics that looks at undiagnosed cases of celiac disease in children. This study examines if doctors were able to predict if a child had celiac disease based on the current detection guidelines.
The main objective of the study was to find out if doctors could predict the children that had undiagnosed celiac disease from using the current celiac disease detection guidelines. The study took place in Sweden and tested over 7,000 children for celiac disease. Children in the study were given a questionnaire to fill out before the screening asking questions about family history of celiac disease and symptoms commonly associated with celiac disease. The results showed that over 2% of the children had undiagnosed celiac disease. The authors found the results of the questionnaire not helpful in detecting if a child had celiac disease. Also, the symptoms commonly associated with celiac disease were not a predictor of if a child would have celiac disease or not.
This is not the first study to show that detection guidelines do not predict all cases of celiac disease but it is one of the largest studies. Previous studies conducted in the United States and Sweden with adults have shown that symptoms do not necessarily predict celiac disease. Dr. Murray says this leaves doctors with a detection dilemma. Who do doctors test for celiac disease and what do they do about people who want to go on a gluten free diet? Some doctors believe it is acceptable for people who do not have symptoms of celiac disease to go on a gluten free diet but this study may change that. Patients may need to be tested before they go on a gluten free diet because it is unsure who will or will not have celiac disease.
There are a lot of celiac disease cases that goes undetected and Dr. Murray says doctors and scientists need to figure out how to detect it.
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For more information on celiac disease, visit mayoclinic.org/celiacdisease.
Dr. Murray is a gastroenterologist and celiac disease expert at Mayo Clinic.