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What Determines When Doctors Test for Celiac Disease?

Celiac.com 05/25/2015 - Many people who are concerned that they may have celiac disease are not sure where to begin. Many people simply stop eating gluten and call it a day, choosing to avoid what can be a long, drawn-out process of getting an official diagnosis.

Photo: CC--Seattle Municipal ArchiveIf you suffer from any of the 10 Most Common Complaints of Celiac Patients, you might want to consider the possibility of celiac disease.

Most doctors, however eager they may be to render proper treatment, are bound by clinical treatment protocols and guidelines that limit the circumstances under which they can order blood screens for celiac disease.

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So, when should doctors test people for celiac disease? According to the American College of Gastroenterology's (ACG) clinical guideline on diagnosis and treatment of celiac disease, people should be tested for celiac disease if they have:

  1. Signs and symptoms of malabsorption, including chronic diarrhea with weight loss, steatorrhea, abdominal pain after eating, and bloating.
    Or
  2. Laboratory evidence of malabsorption, particularly in people who have a first-degree family member with a confirmed celiac disease diagnosis. This includes associated nutritional deficiencies.
    Or
  3. A personal history of an autoimmune disease, or an IgA deficiency.
    Or
  4. Biopsy-proven DH, iron-deficiency anemia refractory to oral supplementation, or hypertransaminasemia with no other origins.

It's interesting to me that the above guidelines don't match up very well with the top ten physical complaints of people who have celiac disease. Those complaints are: Osteopenia/Osteoporosis; Anemia; Cryptogenic hypertransaminasemia; Diarrhea; Bloating; Aphthous stomatitis; Alternating bowel habit; Constipation; Gastroesophageal reflux disease and Recurrent miscarriages.

What do you think? Do doctors need to have more freedom to conduct blood screens when considering the possibility of celiac disease?

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1 Response:

 
Michael
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said this on
01 Jun 2015 8:05:29 AM PST
Ever since 2008, I have been in favor of a national program of testing everyone for celiac disease. Doctors should certainly have the freedom to conduct blood tests. Doctors should know the 300 most commonly associated symptoms, and it does not matter how common among celiac patients their symptoms are or how many symptoms of celiac they have. A thorough history of symptoms should be taken, and if all or most are associated with celiac disease, the doctor should strongly suspect celiac disease.




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