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Testing methods for celiac disease

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  • To help diagnose celiac disease, your physician will first inquire about your medical and family history, especially if you already have a close relative with celiac disease
  • After undergoing these tests, your physician can refer you to a gastroenterologist who will perform an endoscopic biopsy to look at your GI tract

Testing for celiac disease is vital to keep its symptoms from worsening. The Celiac Disease Foundation suggests the following groups of people prioritize screening for this disorder:1

Children age 3 and above or adults exhibiting the hallmark symptoms of celiac disease

First-degree relatives of individuals who have been diagnosed with celiac disease

Individuals diagnosed with conditions linked to celiac disease, including:

Type 1 diabetes mellitus

Autoimmune liver or thyroid disease

Down syndrome

Williams syndrome

Turner syndrome

Selective immunoglobulin A (IgA) deficiency

Initial steps in celiac disease diagnosis

To help diagnose celiac disease, your physician will first inquire about your medical and family history, especially if you have a close relative with this illness. A physical exam may also be done, which involves:2

  • Checking the body for rashes or signs of malnutrition
  • Listening to sounds in your stomach using a stethoscope
  • Tapping your abdomen to examine for pain and fullness or swelling

A dental check-up may be advised as well, since enamel defects, which look like brown, white or yellow spots on the teeth, are sometimes an indicator of celiac disease.3

Tests used to identify celiac disease

Your physician may recommend that you take any of these tests to confirm that you have celiac disease:4,5

Serology test — This test looks for antibodies in your blood. Elevated levels of antibody proteins are common among those with untreated celiac disease, because of the body’s reaction to gluten.6 Eating foods with gluten is a must if you’re taking this test to ensure accurate results.

The tissue transglutaminase antibodies (tTG) test is the preferred method for diagnosing celiac disease, as it has a sensitivity of 93%. Meanwhile, other blood tests used for celiac disease look for endomysial antibody (EMA) and deaminated gliadin peptide (DGP IgA and IgG).7

Genetic test — This involves looking for two human leukocyte antigens called HLA-DQ2 and HLA-DQ8 via a blood test, saliva test or cheek swab. These genes are present in people with celiac disease.8

If the test results are negative, it’s unlikely that you have celiac disease. Keep in mind, though, that testing positive for one or both of these genes doesn’t mean that you automatically have celiac disease.9 Your physician may recommend you to undergo additional test before making a diagnoses. The Celiac Disease Foundation recommends that these people take a genetic test:10

People following a gluten-free diet, as a celiac antibody test might not be accurate

People whose diagnosis of celiac disease isn’t clear because of:

Ambiguous antibody testing results

Equivocal intestinal biopsy results

Discrepancy between antibody and biopsy findings

Relatives of people with celiac disease

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The final diagnostic method for celiac disease

After undergoing these tests, your physician can refer you to a gastroenterologist who will perform an endoscopic biopsy to look at your GI tract. This is the final step in the diagnostic process for celiac disease. The procedure lasts for less than half an hour and utilizes sedatives or local anesthesia.11,12

The first part of this procedure is an endoscopy, which uses a long and thin tube with a camera at the end. The tube is inserted through your mouth and goes down to the esophagus and into the small intestine via the entryway called the duodenum.13,14 This enables your doctor to take a look at the lining of your small intestine. They may also take a small tissue sample to analyze the damage to the villi.15

On the other hand, if there are signs of dermatitis herpetiformis, a condition characterized by itchy, burning and blistering rashes, a skin biopsy may be performed. Tiny pieces of skin tissue are taken and tested to verify the presence of antibodies common in celiac disease. If antibodies are present, further blood tests are done to confirm if the patient has celiac disease.16,17

MORE ABOUT CELIAC DISEASE

Celiac Disease: Introduction

What Is Celiac Disease?

Celiac Disease In Children

Celiac Disease Causes

Celiac Disease Types

Celiac Disease Symptoms

Celiac Disease Diagnosis

Celiac Disease Treatment

Celiac Disease Prevention

Celiac Disease Diet

Celiac Disease FAQ

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