Internet search data can help in diagnosing Coeliac Disease.

Our lives are more and more connected to and spent on internet. Everything that we do online leaves a trace, a piece of data that can be analysed and now medical research is tapping into this biggest database of all.

In April the Journal of Medical Internet Research published the article “Symptoms Prompting Interest in Celiac Disease and the Gluten-Free Diet: Analysis of Internet Search Term Data”

The study was conducted in the US where they have analysed the data from the Bing search engine. They examined the search queries (in English only) for a 10 month period that were related to Celiac Disease – all queries that contained word “celiac” or “gluten”. Their goal was to find out whether search engine data can show symptoms that could help identify people who are more likely to then be diagnosed with coeliac disease.

They analysed the data from the search queries of more than 90,000 people of which 93% were classified as those with a “passing interest” in celiac disease and the remainder with a “sustained interest”. The first group entered their queries into the search engine over one day only, and the second group over more than one day.

Analysis of the search engine queries showed that the common symptoms of coeliac disease such as ‘diarrhoea’, were the first search terms, followed by ‘celiac’ or ‘gluten’ some days afterwards.

But the authors have also had some unexpected findings when apart from the conditions and diseases associated with celiac disease their research have also shown subsequent “celiac-related-queries” or CRQs following searches for cough or asthma which are not acknowledged to be coeliac disease manifestations.

Symptoms external to the gut such as depression, headache or anxiety were also directly connected with CRQs that followed which is “…raising the possibility that neuropsychiatric symptoms are a more prominent set of clinical features in celiac disease than is generally recognized.”

The study also showed some unexpected results, with additional “celiac-related-queries” or CRQs searches for symptoms such as ‘cough’ or ‘asthma’ not normally associated with coeliac disease. Other CRQ’s included ‘depression’, ‘headache’ or ‘anxiety’, which the authors noted as “raising the possibility that neuropsychiatric symptoms are a more prominent set of clinical features in celiac disease than is generally recognized.”

The authors concluded that their analysis of search queries showed an increase in searches for symptoms commonly associated with coeliac disease, such as bloating, weight loss and diarrhoea, preceded the first-time search for ‘Celiac Disease’. The increased searches for “neuropsychiatric symptoms” such as depression and anxiety may be a significant feature among people before they seek to confirm coeliac disease with testing.

Lebwohl B, Yom-Tov E Symptoms Prompting Interest in Celiac Disease and the Gluten-Free Diet: Analysis of Internet Search Term Data J Med Internet Res 2019;21(4):e13082 URL: https://www.jmir.org/2019/4/e13082 DOI: 10.2196/13082 PMID: 30958273 PMCID: 6475820