Should You Be Screened for Celiac Disease?

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If you have a parent, sibling, or child withceliac disease, you should be tested for it,even if you don’t have symptoms or signs of the condition, according to a 2017 review article in theJournal of the American Medical Association.

This advice comports with recommendations from the American College of Gastroenterology; the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition; and the National Institutes of Health, which recommend offering screening to first-degree relatives (parent, sibling, child) of people with celiac disease and to individuals with other autoimmune illnesses such as type 1 diabetes. One outlier is the U.S. Preventive Services Task Force, which concluded last year that there is currently not enough evidence regarding the benefits and harms of screening asymptomatic individuals to support such screening-even for those who may be at risk because of family history.

How great is the risk?

Up to 1 percent of the U.S. population has celiac disease, which is triggered by gluten (a protein in wheat, rye, and some other grains), but first-degree of people with the disease have about a 10 to 15 percent chance of developing it. There is no known risk for more distant relatives.

Many people with the condition don’t experience typical symptoms-or any symptoms at all. The diagnosis is often made when tests are done to explain the underlying cause of some seemingly unrelated medical problems, such as unexplained iron-deficiency anemia or osteoporosis, for example. Diagnosing (initially via a blood test) and treating this genetic autoimmune disease can help prevent intestinal damage and serious complications.

Some people who do not have celiac disease also have adverse effects after consuming gluten, which are similar to the gastrointestinal symptoms of celiac disease. Thus, it’s important to get diagnosed if you think you have a problem with gluten. Don’t go on agluten-free dietbefore being tested for celiac disease, since that can interfere with the results.

Bottom line

Until there is clear evidence that screening is harmful, people who are at risk should be offered screening.