Screening for Celiac Disease Not Recommended for Asymptomatic Patients

The US Preventive Task Force (USPSTF) announced that there is not enough evidence to assess the benefits and harms of screening for celiac disease in asymptomatic patients.

Celiac disease is a chronic condition that results in damage to the lining of the small intestine. The disease is triggered by the ingestion of products containing gluten, and it affects approximately 1% of the population.

The USPSTF reviewed the evidence on the accuracy of screening in asymptomatic children, adolescents, and adults; potential benefits and harms of screening versus not screening and targeted versus universal screening; and the benefits and harms of treatment of screen-detected celiac disease.

Contextual information on the prevalence of celiac disease among patients without obvious systems and the natural history of subclinical celiac disease were also reviewed.

“There are a group of individuals who have asymptomatic celiac or have subtle symptoms,” Dr Alexander Krist, a member of the USPSTF, told National Public Radio (NPR) . “Our main message is just that there really isn’t evidence right now to say whether checking people if they don’t have any signs or symptoms is beneficial.”

The task force has call for more studies, especially of individuals who are at a higher risk for celiac, including those with a family history and individuals with type 1 diabetes.

Determining whether to test a patient for celiac disease is a challenge among physicians because of the wide range of symptoms associated with the condition.

“It’s extremely weird in its clinical presentation,” Dr Ivor Hill, director of the Celiac Disease Center at Nationwide Children’s Hospital, told NPR. “Although the disease affects the intestinal system, in fact, more than half of patients have symptoms that are not even related to the gastrointestinal tract.”

Patients diagnosed with celiac can experience weight loss, diarrhea, abdominal pain, chronic pain, anemia, osteoporosis, peripheral neurological issues, and infertility.

“I think you’ll get people on both sides of the fence who deal with celiac disease,” Hill told NPR. “There are those that avidly recommend everybody should be screened, and others who say, ‘No, because we don’t know, [I’d] rather follow those people closely and, if they develop symptoms, consider screening.”

Testing for celiac disease involves a simple blood test called the tTG-IgA test, which looks for higher-than-normal levels of certain antibodies.