When someone is diagnosed with recurrent diarrhea, abdominal bloating and malabsorption, it might be caused by celiac disease. Some other conditions can also cause malabsorption and malnutrition, especially when the pancreas is unable to produce digestive enzymes. Crohn’s disease, which affects the small intestine or bacterial overgrowth, can also cause these conditions. A celiac disease test can confirm whether those symptoms are caused by celiac disease or not.
What Is Celiac Disease?
Celiac disease occurs when a person is unable to digest foods containing gluten because it causes damage to his/her small intestine. It is an immune disorder, where an immune reaction attacks the small intestine on ingestion of gluten. Celiac disease is different in different people, and can affect the digestive system as well as other parts of the body.
Some of the symptoms are diarrhea, pain in the abdomen, irritability and depression. Children exhibit irritability the most and some people might remain asymptomatic. Celiac test can determine the condition. Gluten is a protein which is found mainly in wheat, rye and barley and food stuff made from these cereals. It can also be found in medicines, vitamins, cosmetics and the glue used on stamps and envelopes.
Celiac Disease Tests
Since the symptoms of celiac disease are similar to other disorders, it is important to know how to diagnose celiac disease. Other diseases which can be confused with celiac disease are irritable bowel syndrome or inflammatory bowel disease, diverticulitis, infections of the intestine, chronic fatigue disease and iron-deficiency anemia which is caused by menstrual blood loss. This causes celiac disease to be wrongly diagnosed or under diagnosed. Various celiac disease tests can be prescribed when more symptoms are revealed.
1. Antibody Blood Tests
One of the important celiac disease tests is the antibody blood test which checks for antibodies specific to celiac disease. The most preferred test is IgA anti-tissue transglutaminase antibody. Other tests are to detect the presence of IgA endomysial. Another antibody – AGA is also tested; however, positive result does not necessarily mean presence of celiac disease. But it is good to determine the response to treatment. The level of AGA falls when you follow a gluten free diet.
Note: Don't go for gluten-free diet before the test. When one stops eating foods including gluten, the test results may be negative for celiac disease no matter one has the disease or not.
2. Intestinal Biopsy
If the blood test reports suggest celiac disease, biopsy is performed. A small piece of the small intestine is removed by the doctor and damage to the villi of the intestine is checked. The biopsy is performed by inserting an endoscope through the mouth and stomach till it reaches the small intestine. The endoscope has instrument by which a tiny piece can be removed to be checked for damage.
3. Dermatitis Herpetiformis
Around 15 to 20% of people suffering from celiac disease have dermatitis herpetiformis. It is an intensely itchy rash which causes skin blisters and occurs on elbows, knees and buttocks. People with this symptom usually do not display any digestive symptoms associated with celiac disease. This is also diagnosed by performing blood test and skin biopsy. Anti-body tests and skin biopsy can usually determine DH. Antibiotics are prescribed along with gluten free diet.
4. Genetic Testing
One or both of HLA DQ2 and DQ8 genes are usually seen in people with celiac disease. But it is also present in 40% of normal individuals, hence the presence of these genes does not mean a person has or will develop celiac disease. It is done when other tests are inconclusive and/or are relatives. The test can be done by blood tests, testing saliva or taking cheek swabs.
Celiac Disease Treatment
Once the celiac disease test is performed and the diagnosis is confirmed, one of following methods of treatment can be used:
- Gluten-free diet: Once gluten is eliminated from the diet, the symptoms gradually disappear and should be maintained lifelong. The villi of the small intestine will need some time to get healed, for adults that time would usually be 2 years. It is important to test for nutritional deficiencies for iron, folic acid, vitamin B12 & D.
- Consult your dietitian: A dietitian can help in identifying foods which contain gluten and also help in planning meals without gluten. You can make proper choice when grocery shopping etc.
- For unresponsive celiac disease: When people do not respond positively to gluten free diet, it is referred to as unresponsive celiac disease. The damage to the intestine is severe and there are chances that it might not heal. Intravenous nutrition might be required for such individuals and gastroenterologists might be consulted.