How to Test for Celiac Disease
If you’re exhibiting any of the symptoms for celiac disease, it’s important to consult with your doctor as soon as possible. Your doctor should be able to assess your symptoms and point you in the right direction moving forward. If it’s determined that you should be tested for celiac disease, there is a specific protocol that will be followed.
The Celiac Disease Foundation also recommends that parents, siblings, or children of people who have already been diagnosed with celiac disease should also consider getting screened. They state that these close relatives have a 1 in 10 chance of being diagnosed compared to the general population which is closer to 1 in 100.
Lastly, if you suffer from any of the following conditions, you should also talk to your healthcare professional about getting screened:
- An autoimmune thyroid or liver condition
- Type 1 diabetes
- Multiple Sclerosis
- Sjogren’s syndrome
- Arthritis
- Addison’s disease
The Celiac Disease Foundation has a more extensive list of conditions that are commonly associated with celiac disease. Please consult this list for more information.
Screening for Celiac Disease
A proper screening is the first step in reaching an eventual celiac diagnosis. This is done with a blood test to determine what antibodies are in the blood.
When a person with celiac disease eats a gluten-containing food, the body releases certain antibodies as a response to the gluten which it sees as harmful. The presence of these antibodies is what can be seen in a blood test, and can warrant further investigation into whether the person has celiac disease.
While there are a number of different screenings that can be done, the most common is a screening for the Tissue Transglutaminase IgA antibody (tT-IgA). This is the most sensitive test and is usually the first test in the screening process.
The tT-IgA test is positive in about 98% of people who have celiac disease and are still eating a gluten-containing diet. That being said, there is still a chance that the test can come back as a false positive or false negative.
There are a few other tests that can be done to help eliminate any false results. These include testing for IgA Endomysial antibody (EMA), total IgA, and Deaminated gliadin peptide (DGP IgA and IgG).
Something important to note – for an antibody screening to be completed successfully, the person getting tested must be consuming gluten at the time of the test since gluten is what triggers the influx of the specific antibodies. There has to be a certain amount of gluten in the body for the antibody test to be as accurate as possible. If the person requesting the test has been gluten-free for any amount of time, the doctor may recommend undergoing a gluten challenge. This is a specific protocol
Genetic Testing
People with celiac disease have the either one or both of the genes HLA DQ2 and/or DQ8. These genes don’t automatically signal the presence of celiac disease though as up to 30% of the general population also carry these specific genes. But, if the test comes back negative, this means that the individual has a 99% chance of not developing the disease in the future.
This can be incredibly important information to have for first-degree relatives of a person with celiac disease. Most celiac experts recommend that children whose parents have celiac disease be tested to determine if the child has either of those genes; if the test comes back positive, there will need to be periodic antibody screening for the development of the disease throughout their lifespan.
Unlike the antibody test, a person can be on a gluten-free diet and take this test. If a person has been gluten-free for a while, and wants to figure out if celiac disease is present, a genetic test might be a better option.
Diagnosis
It’s important to remember that positive screenings don’t imply a 100% chance of having celiac disease. If the screenings do come back positive or indeterminate, a intestinal biopsy has to be completed to confirm the diagnosis.
This procedure will allow the doctor to look at tissue from your small intestine – specifically the villi that live on the lining of the intestinal tract. Damaged villi are a common sign of celiac disease. At that point, a true diagnosis can be made.
If the biopsy comes back positive, your doctor will consult with you on specific treatment moving forward. A gluten-free diet will be essential.
Sources:
https://labtestsonline.org/understanding/analytes/celiac-disease/tab/test
http://www.cureceliacdisease.org/wp-content/uploads/341_CDCFactSheets3_Antibody.pdf
This is the “testing” section of our celiac guide series. Check out the other installments below:
- The Ultimate Guide to Celiac Disease
- Symptoms of Celiac Disease
- Treatment for Celiac Disease
- Celiac Disease & Your Diet
- Awareness of Celiac Disease
- Celiac Disease & Our Anatomy
- Celiac Disease & Weight Gain
- Celiac Disease & Alcohol
- Celiac Disease FAQ
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