We Are Trying To Rule Out Celiac Disease

[Flmom2306]

I have a 8 year old daughter who has complained of a stomach ache for 7 1/2 weeks now. It started when I had to pick her up from summer camp one day for severe stomach pain. I gave her some advil on the way home and she perked up a bit. Everyday since she has complained of a stomach ache, morning til night. Sometimes it is worse, sometimes better. School started this week ,so last week I took her to the pediatrician. He said her liver felt fine, her spleen was fine, and she had no area of sensitivities when he palpated her belly. She has had no fever, diarrhea, or vomitting. No sign of any illness other than stomach ache. 99 percent of the time, she is able to carry on normal activites and just state that her stomach hurts. The pediatrician believes it is stress, however I am not so sure. I called back today and requested a referrral to a peds GI doc. We live in a small town and the peds Gi only comes 2 times a month. I can't get in until mid September. The nurse told me the first thing the GI doc will do is eliminate gluten so to start eliminating now, and keep a food journal. I reading about celiac's disease, they talk about fatty, floating stools. Her stools have ALWAYS been huge in diameter, I can't believe that they came out of my petite girl, and they are usually a tan to yellowy to grey color. Do symptoms come on suddenly, or is it possible that her stool has always been a sign and we just missed it? What should I expect on the first appt?? Is there some definite test other than food challenge to determine celiacs?????

[kareng]

Your child must be eating gluten to get a positive blood test.

[GottaSki]

Yes, there are blood tests that can be run. These tests need to be run before you remove gluten from your daughter's diet. I'd have the primary order the blood tests - this way they will be ready for the GI to review rather than the GI having to order at your initial visit.

Once the blood is drawn remove ALL gluten from her diet - this can be a very tough transition but will ease with time. The reason I suggest going straight to the diet after blood is it is often the best test in children (blood and biopsy can be false negative). Given that she is in pain daily it makes sense to trial the gluten-free diet as it can't hurt and very well may help!

Many primary doctors will only run a tTG IgA (Tissue Transglutaminase IgA) to screen for Celiac Disease, but you should request a full celiac panel as these tests can not be done after removing gluten (IMHO if your doctor's nurse knows that the GI will likely start a gluten-free diet - she/he should also BE AWARE that the blood tests can not be run after gluten has been removed and therefore should be ordered first).

Full Celiac Blood Panel:

Total Serum IgA

Tissue Transglutaminase IgA and IgG

Gliadin IgA and IgG

Endomysial Antibody IgA

Deamidated Gliadin Peptide IgA and IgG

Also, low vitamins/minerals can indicate your daughter is not absorbing nutrients properly - another indicator of Celiac Disease. So you might want to have these drawn at the same time as the Celiac panel.

Misc blood tests:

Bs, D, K, Iron, Ferritin, Copper and Zinc

Good Luck to you and your daughter!