Celiac Disease and Malabsorption

Question:

My 14-year-old son has celiac and has been gluten-free for 2 years.  A recent endoscopy showed none of the damage he had previously.  However, he still passes copious amounts of stool daily, but there is no more cramping and the stool is well formed and passes easily.  Should I be concerned with malabsorption because of the large amount of stool he passes, or is this typical of celiac sufferers?

Answer:

Gastrointestinal symptoms are not expected in patients who have adequately treated celiac disease.  Adequately treated celiac disease means strict compliance with a gluten-free diet that leads to normalization of the celiac panel and normalization of the biopsy findings.  As such, your son’s symptoms are unlikely to be secondary to celiac disease.  In addition, as long as the stool is formed and your son is growing appropriately, malabsorption is probably not occurring.  However, if you think that the frequency of bowel movements and the amount of stool is excessive, it would be worthwhile to talk to your son’s GI doctor.  Additional testing may need to be performed to make sure that there is not another reason for the symptoms such as an infection, irritable bowel syndrome or inflammatory bowel disease.

Sincerely,

The Center for Celiac Disease at The Children's Hospital of Philadelphia

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