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Almost any pediatric health care provider will substantiate the significant disease burden of “abdominal pain.” Although an understanding of a patient’s medical history and a careful physical examination can guide a clinician, in many cases, there persists the difficult task of deciding who and how to test when the etiology remains uncertain. One important resource is the Rome criteria and classification system to diagnose symptoms and to treat and manage children with suspected functional gastrointestinal disorders (FGIDs). However, as highlighted in the most recent clinical report on chronic abdominal pain in children from the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN), several gaps exist in the current understanding of functional diseases in children.1 The report plainly indicates that future research concerning chronic abdominal pain should examine the methods of testing patients with suspected FGIDs, as well as any disease processes that the tests uncover. A study in this issue of JAMA Pediatrics by Cristofori et al2 tries to address this paucity of knowledge. The authors extend recent discoveries in the adult population3 to the pediatric population and report a 4-fold higher prevalence of celiac disease among children who meet clinical criteria for irritable bowel syndrome (IBS). With this important new information arises the obvious question: is celiac disease screening warranted for all children with a suspected functional etiology for their abdominal pain?
Squires JE, Fei L, Cohen MB. Role of Celiac Disease Screening for Children With Functional Gastrointestinal Disorders. JAMA Pediatr. 2014;168(6):514–515. doi:10.1001/jamapediatrics.2013.5418
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