The number one thing i need to mention regarding getting tested for celiac disease is that if you are already on a gluten free diet — the testing (other then the genetic markers test -HLA DQ2 and HLA DQ8 genes) will all be ineffective. So if you are wanting to get a confirmation with a medical diagnosis you need to have the testing done BEFORE you go on a gluten free diet. If you have already been on a gluten free diet and now wish to get tested you will need to reintroduce gluten into your diet. Current ‘guess’ to how much gluten you need to eat is equivalent to eating 1-4 slices of bread (gluten) a day for at least 6 weeks. Testing might still be negative in some people & they will need to reintroduce longer.
Diagnosing Celiac Disease:
The first line of diagnosis is conducting a few blood tests (celiac panel). IgA-human tissue (TTG) can detect the presence of celiac disease to approximately 90% accuracy. The IgAendomysial antibody (EMA) test is often ordered along side the TTG test and sometimes a IgA serum test is ordered along side as well. The TTG or EMA test can be ordered (one or the other) or a combination of all three tests. Both the TTG & EMA have the same approximate accuracy. The IgA serum test is used to detect an IgA deficiency. If your body does not make enough IgA then the TTG & EMA may show a false negative. IgA dificiency occurs in about 3-5% of patients with celiac disease. The rate of accurate diagnosis in children is much lower as it can be hard to get a definitive answer in children under the age of 3 years old.
Second line of testing is a biopsy done of the duodenum or jejunum (upper endoscopy) taking 4-8 samples and checking for scalloping of the small bowel folds, mosaic pattern to the mucous membranes, or any protrusion of the submucosa blood vessels or nodular patterns.
Currently the only effective treatment is a life long and strict gluten free diet. Any wavering from the diet – intentionally or not – can cause a relapse in symptoms. There have been some recent studies and trials that are testing alternative or additional treatments for celiac disease but the current safest & most effective is a gluten free diet.
Up Next: The Gluten Free Diet
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