<<Disclaimer: Verify this information before applying it to your situation.>>

Recently I posted a link to an article written by a Stanford geneticist...
http://www.thetech.org/genetics/ask.php?id=154
...addressing the issue of Celiac screening in siblings.

I received a variety of criticism for this article.  I would like to address some of these emails in our forum.

First of all, neither this article, nor any one article, can replace individualized diagnosis and treatment by a gastroenterologist.  Such a physician can evaluate a person's symptoms and patient history and determine precisely which screening methods are appropriate.  There are most definitely physicians in the United States and abroad that specialize in the area of Celiac diagnosis and treatment, and their expertise should never be replaced by anecdotal evidence or heresay.

Second, several readers pointed out to me that recent studies have shown that serological blood screening for Celiacs can yield false negatives.  Again, this is a concern that should be discussed with a physician, especially in the screening of an asymptomatic relative.  I am also aware that in recent years Dr. Kenneth Fine has proposed the screening of stool for Celiac antibodies.  This may be another alternative screening procedure.

Finally, one reader told me that the author of the article was wrong because he/she had been screened for "Celiac genes."  As a former scientist (although not a geneticist or Celiac researcher), I did some reading on this issue.  I found that particular genes of the immune system often indicate a predisposition to Celiac.  However, the accepted belief is still that these genes must be "triggered" by environmental factors.

According to Drs. Ludvig Sollid (University of Oslo) and Karoly Horvath (University of Maryland) in their website addressing questions about Celiac and genetics (http://www.enabling.org/ia/celiac/cel-hla.html#Q3), approximately 25-30% of the population of Europe has the specific HLA genes associated with Celiac.  Research indicates that most of these people do not have Celiac, asymptomatic or symptomatic.  These particular researchers do not recommend the HLA screening except as a confirmatory procedure in the case of doubtful serological or biopsy results.

I encourage you to read the webpage by Drs. Sollid and Horvath if you have other questions about the HLA genes and screening.  They have a very clear and concise "Q&A" section.

I'm sorry that many people have received frustrating test results or confusing information from inexperienced family physicians.  However, my experience in the world of science has led me to believe that research is very dynamic, popular opinions change, and that increasing technological advances will someday make all of this easier.  I hope that such a day comes soon.

Happy Holidays, happy eating.
Jessica in Boston

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