My son had been on a gluten free diet with great success for about 5 months. After talking to his pediatrician we decided to do a gluten challenge and have him scoped to test for celiac disease. He has been on gluten again for 2 days and after the first day his stools are very loose and smell horrible again.I went to his room after his nap and I already knew that he had pooped when I opened the hallway door, his room is all the way at the end of the hall and his door was closed. Today he had 6 bowl movements (usually he has 2, maybe 3 at the most)and now has started to develop a rash on his scrotum and around his anus area. So far he doesn't seem to be in pain with a stomach ache or anything to that extend.
His pediatrician is planning on doing the blood test in July and than in August we get the scope done.
My question is what would we do if he gets really sick from this over the next couple of weeks. Should we still continue the challenge? How long should he be on gluten in your opinion?
Thank you

Hi,

Has he had a screening IgA and a serum tissue transglutaminase level? These are the definitive tests to screen for celiac and if they are positive, this is almost certainly what he has. A gluten challenge consisting of a slice of bread or two each day for a couple of weeks should give all the challenge you need. If the TTG test is positive, then a biopsy is performed. If this is positive and it almost certainly will be, then a GF diet is used for about 6 months and the TTG test should decrease or return to normal.

This is the usual way the pediatric GI docs and pediatricians make the diagnosis.

Good luck, Dr. Olson