Diet and Nutrition

This Test Accurately Diagnoses Celiac Disease For Those Already Gluten-Free

This Test Accurately Diagnoses Celiac Disease For Those Already Gluten-Free

Celiac disease is an autoimmune disease in which an immune response is triggered by gluten in the small intestine. This response will gradually damage the villi or the small projections shaped like fingers in the small intestine. This makes it difficult for the body to absorb nutrients properly.

The disease is hereditary. People who have first-degree relatives with celiac disease have a ten percent chance of developing the disease. Children with celiac disease will have issues with growth and development. Since there is no cure for this disorder, following a gluten-free diet manages the symptoms and allow the intestine to heal. But, those who may already be on a gluten-free diet, the disease is a lot more difficult to diagnose because the patient is not exhibiting the common symptoms when gluten is ingested. 

That is, until now. A new test has been developed for those who do not have a formal diagnosis of celiac disease, but follow a gluten-free diet anyway. 

The current testing for celiac disease

To diagnose celiac disease, two tests may be ordered by the doctor:

  • Serology testing – This test looks for antibodies present in the blood. When there is an elevated level of certain antibody proteins, it may result in an immune reaction to food with gluten.
  • Genetic testing – This test is used on human leukocyte antigens to rule out the possibility of celiac disease from developing.

When the tests show the possibility of celiac disease, a biopsy will be ordered by the doctor to confirm the diagnosis. Despite advances in serological testing, a duodenal biopsy is still considered as the best way to diagnose celiac disease among most patients. However, a biopsy may not be necessary with the improvements in serology evaluations and a better understanding of the genetic risk factors associated with celiac disease.

What are the issues with the current testing methods?

While current celiac disease tests are accurate when it comes to detecting the disease, the accuracy of the test may be affected if the patient is on a gluten-free diet. Due to this, they will have to go through a gluten challenge before being tested. In addition, there are instances when a false positive test result may occur among people without celiac disease.

A false positive result comes when a patient is also suffering from other autoimmune disorders. These disorders include Hashimoto’s thyroiditis, type 1 diabetes, rheumatoid arthritis, and autoimmune liver disease, among others. In situations, it is necessary to go through other tests to double-check these false positive test results. But, a biopsy of the small intestine is considered the best method for diagnosing celiac disease.

But, what is a gluten challenge?

People who have started a gluten-free diet without being tested for celiac disease have to go through a gluten challenge so that the antibodies can enter the bloodstream before the test. The gluten challenge involves eating two slices of wheat-based bread for six to eight weeks. It is also important for a doctor with celiac disease training to supervise the challenge, in case of any severe reactions that the patient may have. The doctor will also perform the duodenal biopsy in case the symptoms present themselves and are severe.

However, pregnant women should not go through a gluten challenge.