5 Questions Find Hidden Celiac Disease in Kids

Questionnaire Helps Identify Kids Who Need Gluten-Free Diet

Medically Reviewed by Brunilda Nazario, MD on February 01, 2010
From the WebMD Archives

Feb. 1, 2010 - Five simple questions can help you find out whether your child needs a gluten-free diet, Danish researchers suggest.

Many children have celiac disease, a disorder that causes damage to the intestines when food containing gluten is eaten. Such kids do much better on a gluten-free diet. Foods containing wheat, oats, and barley give them trouble.

But at least half of kids with celiac disease never get diagnosed, and thus needlessly suffer symptoms such as diarrhea, abdominal pain, and behavior problems.

There's a blood test that tells doctors which kids likely have celiac disease. But it's impractical to give all kids the blood test. Might it be easier to test only kids who have one or more symptoms of celiac disease?

To find out, Peter Toftedal, MD, of Odense University Hospital, Denmark, created a questionnaire for parents. The five items elicit information on recurrent abdominal pain, chronic diarrhea, constipation, and lack of height and weight gain:

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

How well does it work? Toftedal and colleagues tested the questionnaire on Denmark's County of Funen. They mailed it to the parents of 9,880 8- and 9-year-olds. Before giving the questionnaire, 13 Funen kids were known to have celiac disease.

Of the 7,029 parents who filled out the questionnaire, 2,835 reported at least one symptom. All of these kids were invited for a blood test. Of the 1,720 children tested, 24 were positive for the antibodies characteristic of celiac disease.

Further tests identified 14 kids with celiac disease. That means that in Funen, only half of the kids with celiac disease had been diagnosed.

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

The findings appear in the March issue of Pediatrics.