Insufficient Evidence To Screen Asymptomatic People For Celiac Disease Interview with:

Ann Kurth, Ph.D., C.N.M., R.N.

Dr. Ann Kurth

Dr. Ann Kurth, Task Force member
Dean of the Yale School of Nursing
Adjunct professor
New York University College of Nursing and the College of Global Public Health. What is the background for this study?

Response: Celiac disease, an immune disorder where people should not eat food with gluten, is fairly prevalent. When people with celiac disease eat foods containing gluten, which is found in wheat, rye and barley, their body responds by inflaming or destroying villi—the tiny, fingerlike projections on the inner lining of the small intestine–which prevents the body from absorbing the necessary nutrients from food. What are the main findings?

Response: The Task Force found that the current evidence on screening for celiac disease is insufficient, and more research is needed before it can recommend for or against screening people who don’t have any signs or symptoms of the condition. The Task Force did note that, because celiac disease is moderately common and some patients may be at increased risk, clinicians should be aware of the signs and symptoms of this condition and consider screening patients who are experiencing them. Symptoms of celiac disease include diarrhea, abdominal pain, unexplained weight loss, or other symptoms such as fatigue or anemia. Would you briefly explain what is meant by celiac disease?

Response: Celiac disease is a lifelong autoimmune disorder that affects multiple parts of a person’s body and, left untreated, can lead to serious health problems. These can include the development of nerve damage, skin rashes, anemia, osteoporosis, infertility and miscarriage, short stature in developing children, intestinal cancers, and neurological conditions like epilepsy and migraines. Treatment for celiac disease is lifelong adherence to a gluten-free diet, which reverses disease symptoms and progression of damage to the small intestine in a majority of patients. This means avoiding foods that contain wheat, rye, and barley. How is celiac disease related to gluten sensitivity?

Response: Non-celiac gluten sensitivity is not thought to lead to the severe health complications associated with celiac disease. It’s important to note that the Task Force did not review evidence on non-celiac gluten sensitivity because this condition is defined based on the presence of symptoms rather than on diagnostic tests, which means that it is beyond our scope. Who should be screened for celiac disease?

Response: The Task Force concluded that the current evidence is insufficient to recommend for or against screening for celiac disease in people without signs or symptoms of the condition. However, the Task Force encourages those who are concerned about the risk of having celiac disease, as well as people who have a family history of the condition, to talk to their primary care doctor about whether screening is appropriate for them. What recommendations do you have for future research as a result of this report?

Response: In addition to calling for more research on the benefits and harms of screening for celiac disease, the Task Force identified three specific areas for additional research. These areas include research surrounding the benefits and harms of screening in people at increased risk for celiac disease; the health benefits of screening people without signs or symptoms in the general population compared to people who are not screened; and the effect of adherence to a gluten-free diet Is there anything else you would like to add?

Response: Some people may have celiac disease without experiencing any signs or symptoms. The Task Force encourages people who are concerned about the possibility of having celiac disease to talk to their primary care doctor about whether screening is appropriate for them. Thank you for your contribution to the community.


US Preventive Services Task Force. Screening for Celiac DiseaseUS Preventive Services Task Force Recommendation Statement. JAMA. 2017;317(12):1252-1257. doi:10.1001/jama.2017.1462

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on April 4, 2017 by Marie Benz MD FAAD