Celiac disease: Five Simple Questions Show if Kids Need a Gluten-free Diet

Celiac.com 02/15/2010 - Just five simple questions can help you determine if your child needs a gluten-free diet, according to the a recent Danish study that aims to improve celiac disease diagnosis in children.

Celiac disease is a disorder in which people suffer intestinal damage when they eat foods made with wheat, rye, or barley.

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Over the last five or six decades, rates of celiac disease have increased 400%. Worse still, at least half of kids with celiac disease never get diagnosed.

That means they will continue to eat foods made with wheat, rye, or barley; and that they will suffer persistent symptoms such as diarrhea, abdominal pain, and behavior problems, along with  intestinal damage, that are perfectly avoidable with a gluten-free diet.

A simple blood test can tell doctors which kids most likely have celiac disease. But doing a blood test on every child is simply not practical. Would it be better to test just the kids who show one or more symptoms common to celiac disease?

To answer that question, doctor Peter Toftedal, MD, of Denmark's Odense University Hospital, created a simple, five item questionnaire to help parents provide information on recurrent abdominal pain, chronic diarrhea, constipation, and lack of height and weight gain:

1. Has your child ever suffered from abdominal pain more than twice during the last three months?
2. Has your child ever had diarrhea lasting more than two weeks?
3. Does your child have a tendency to firm and hard stools?
4. Does your child gain enough weight?
5. Does your child gain enough height?

Toftedal's study team conducted a trial of the questionnaire in Denmark's County of Funen. They mailed it to the parents of 9,880 8- and 9-year-olds. Prior to mailing the questionnaire, just 13 children in Funen were known to have celiac disease.

A total of 7,029 parents returned the completed questionnaire, with 2,835 reporting at least one symptom. The research team invited these children for a celiac blood screen. A total of 1,720 children submitted to screening, with 24 showing positive antibodies common with celiac disease.

Additional testing confirmed 14 case of celiac disease among the children of Funen, meaning that only half of the kids with celiac disease had been diagnosed. When you factor in the additional 1,115 parents who did not report for screening, the result might be slightly higher.

Toftedal and colleagues conclude that a number of "preclinical and low-grade symptomatic patients with celiac disease may be identified by their responses to a mailed questionnaire."

Pediatrics, March 2010