Many people at risk for celiac are not being tested according to medical guidelines. Columbia University found 30 percent of people with relevant symptoms, who had a first-degree relative with celiac disease, were not screened.
Current national guidelines do not recommend screening people without symptoms. However, experts call for a more aggressive approach to diagnose patients early and improve their outcomes. Even patients without symptoms benefit from going gluten free because they have fewer digestive problems, less intestinal damage and less anxiety about the illness.
Studies estimate the disease affects 10 percent of people who have a first-degree relative with celiac. To achieve earlier diagnosis, guidelines recommend screening parents, siblings and children of those with celiac.
Columbia University Irving Medical Center and New York-Presbyterian Hospital compiled medical data from relatives of 2,081 patients with celiac, identifying 539 relatives who later attended the center. In this group, 39.3 percent were tested for celiac. Among 165 first-degree relatives with celiac symptoms, only 71.5 percent were screened. Screening was much more likely for patients seen by a gastroenterologist (rather than another type of doctor) and those who had a family history of celiac clearly documented in their health records.
The authors speculate screening may be even less common in institutions that, unlike Columbia, do not specialize in celiac. This study calls for including family history in electronic health records and wider screening of first-degree relatives.
Faye AS, Polubriaginof F, Green PHR, Vawdrey DK, Tatonetti N and Lebwohl B, “Low rates of screening for celiac disease among family members,” Clinical Gastroenterology and Hepatology, 15 June 2018, doi:10.1016/j.cgh.2018.06.016.