<s>[INST] my grand daughter lives in germany and about 9 months ago she was diagnosed with Lyme decease due to a tick. She under went treatment, but now she is experiencing diarrhea, abdominal pain and bed wetting. Her sister has celiac decease and Alicia was tested and the results said no. any ideas where they should start? [/INST] There are two considerations here.  Lyme disease can recur or become more advanced, so she should be checked for that possibility.  Celiac disease is diagnosed when antibodies to gluten have formed and active disease is in place.  Another test, there HL ADQ antigen test, can be done to determine if she is at risk and if so she could consider electively going gluten-free until older.  The diarrhea, bed-wetting and abdominal pain could be something as simple as a bladder infection.  Please take her to the doctor for an exam. </s>