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  • Jefferson Adams
    Jefferson Adams

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

    Reviewed and edited by a celiac disease expert.

    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.

    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

    Edited by Jefferson Adams


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    I kinda disagree with this type of diagnosis. Those questions would have skipped over me as a child because I don't ever remember having diarrhea issues and abdominal pain didn't seem to be an issue until high school. I also made it to my mom's height. I seemed fairly healthy and very athletic except for the brain fog, etc.

    This disease is so crazy. Not having nutrients wreaks havoc in many different ways. For me it was hyperhidrosis (profuse sweating) under my arms at around fifth/sixth grade. For my daughter, the sweating began around the same time except it was her hands. Our legs also became like basketball skin at that time too. Going gluten-free has been a life-saver and a solution to embarrassment.

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    I do agree with this article although I agree with the points USER made as well. These questions are common-sense and may seem overly simplistic on some level, but I was told as a child my significant underweight was due to a "fast metabolism"(which of course was a crock).

    Therefore I agree with the folks in Denmark and the nations such as Ireland who have dealt with the matter for centuries, while culturally America is just coming up to speed here.

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    Guest brooke pulsinelli

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    I think that these 5 questions are awful and hardly a true sign of the disease. To even publish this is irresponsible and greatly misleading to anyone who is just beginning their search for answers! How disappointing to find this on a celiac web page!

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    I think that these 5 questions are awful and hardly a true sign of the disease. To even publish this is irresponsible and greatly misleading to anyone who is just beginning their search for answers! How disappointing to find this on a celiac web page!

    This is a summary of research that was published in Pediatrics, March 2010...how is it bad to summarize research on celiac disease on a celiac site?

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     What makes me angry is my daughter had so many problems gaining, always small for her age could never keep her formula down had colic for about 2 weeks this is 26 years ago but not a single doctor thought of celiac my daughter as an adult is smaller than myself 5 ft and weight wise still in the double digits.i've just been diagnosed recently and i had the neuro symptoms it took 35 years to figure that one out.

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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