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Doctors Overlook Celiac Disease Symptoms


Question:

My daughter (11) was in urgent care over the holidays w/ abdominal pain so intense she would ball up and cry after eating. She has a history of lactose intolerance. She had severe nausea with no vomiting and experienced bouts of both diarrhea and constipation. Appendicitis was ruled out.  They concerned me when they said she presented with symptoms of gallbladder disease. I got a second opinion. 

I have since removed most gluten products from her diet, and dairy with the exception of Greek yogurt (she says it doesn’t hurt her, but it does make her go to the bathroom). Three weeks later, she is doing great with some dietary changes. 

My concern is that after reading about celiac disease, she has several other symptoms that have been overlooked by physicians over time: a) poor weight gain, b) discolored teeth and soft enamel, and c) eczema. My question is: What tests should I run for malabsorption?

Answer:

First of all, I would make sure that your daughter is being followed by a pediatric gastroenterologist.  Based on the symptoms she is experiencing, it would not be unreasonable to have your daughter evaluated for celiac disease.  There is a blood test that your doctor can request to screen for the disease. However, for the test to be useful, your daughter should be on a gluten-containing diet for at least one month before the blood test is performed. 

Also, it is important to recognize that there are some patients who are sensitive to gluten but whodo not have celiac disease.  This may be the case if your daughter is negative for celiac disease but if removing gluten from the diet seems to improve her symptoms. 

If celiac disease has been ruled out and if your daughter has symptoms suggestive of malabsorption such as weight loss and diarrhea, there are other blood tests and stool tests that your doctor can order to determine if a component of the diet is not being properly absorbed.

Sincerely,

Center for Celiac Disease at The Children's Hospital of Philadelphia

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