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Christine asks: “Hi, my daughter (9 yrs old) was tested for coeliac disease a year ago – her test results were negative, except for the IgG which was 35 (range being 0-20). She has been on Losec (30 mg/day) for reflux since she was 6 years old. But she is still periodically getting symptoms of tummy pain, sore ear and throat, headaches. Question:" Is there any point asking for re-testing for coeliac disease a year after negative results? Could this test now be positive a year later? (Her Dad has a high gluten sensitivity, and is on a strict gluten free diet, although not formally diagnosed as coeliac)." Many thanks for your time. Regards, Christine
I reply: There are three issues here 1) The diagnosis of coeliac disease – when to retest. An important concept in the diagnosis of coeliac disease is that it is a disease in progress. You can develop coeliac disease slowly. The symptoms of gut ache and bowel disturbance can predate the damage to the gut. Therefore, a negative test to coeliac disease (a low tTG) only tells you that you do not have gut damage at the time of the test. A “negative” tTG test does not clear you of getting coeliac disease in the future.
So, Yes! Get your daughter tested again. 2) Gluten sensitivity or The Gluten Syndrome, (also called “non-coeliac gluten sensitivity”)
Your daughter might be gluten-sensitive, but not have coeliac disease (like her father). She has a high gluten antibody test (high IgG-gliadin) and is still consuming gluten. She almost certainly would get fully better if she went on a gluten-free diet. 3) Reflux and gluten
In my experience, most children (and many adults) with on-going reflux are gluten-sensitive. It is unlikely that her reflux will settle without her going on a gluten-free diet. She could even have eosinophillic oesophagitis. It would be a good idea for her to have an endoscopy to check out the health of her oesophagus and small bowel. I hope that this helps. Cheers, Dr Rodney Ford |
