In a pediatric Boston cohort of 579 patients presenting for celiac evaluation but no previous diagnosis, 7.4% had previous gluten avoidance (J Pediatr 2012; 161: 471-5). In this cohort, the mean age at presentation was 8.7 years.
Independent predictors of gluten avoidance and the odds ratio (OR) included the following:
- Irritability OR 3.2
- Family history of celiac OR 2.2
- Diarrhea OR 2.5
- Pervasive developmental disorder OR 5.3
From my perspective, many families and sometimes referring physicians are convinced that their child has celiac disease before subspecialty evaluation. While a gluten-free diet may reduce some gastrointestinal symptoms even in the absence of celiac disease, it is probably helpful for families to complete diagnostic testing and to obtain dietary counseling prior to implementing a gluten-free diet.
Previous related blog entries:
gutsandgrowth 