Faecal occult blood in children with coeliac disease

It has recently been suggested that in adults with coeliac disease, faecal blood loss may play a role in the development of iron deficiency. A group o f 45 children diagnosed with coeliac disease during 1996 and 1997 were ther efore prospectively evaluated for the presence of gluten in their diet, iro n deficiency anaemia, and faecal occult blood. Sixty children admitted for elective surgery or asthma served as controls. Faecal occult blood was foun d in four iron deficient children on normal diet, of whom three were newly diagnosed. Occult blood loss disappeared in three of the four children when gluten was removed from their diet. Faecal occult blood was found in 26.7% of children on gluten-containing diet, but not in children on gluten-free diet (P = 0.01), or in control children (P = 0.001). Conclusion Our data suggest that the incidence of occult blood loss in coel iac disease occurs mainly in newly diagnosed cases and responds to a gluten -free diet. Occult blood testing may not be warranted in the absence of iro n deficiency anaemia nor in children with iron deficiency anaemia who are o n a gluten-free diet.