Testing for Celiac Disease
As celiac disease is an autoimmune disease brought about by exposure to gluten, antibodies are produced. The gut itself becomes irritated and then inflamed. Both of these points are important when screening for the illness.
However screening is not routinely done because the tests are not always accurate. By routinely testing a large population there is a good chance of discovering a high number of false positives. That is people who are incorrectly diagnosed as having celiac disease.
What this means is that testing should only be recommended when symptoms are actually present and when there are a number of high risk factors which would increase the likelihood of having the disease, even if there are no symptoms. These factors are environmental, family history, and other medical conditions. Thus, it is best to consult with a doctor to determine whether an individual should be tested.
Family history is crucial as celiac disease does run in the family. If a first level relative has this condition, for example, a parent, child or sibling, then the chance of developing the disease is higher for certain people. The number can be as high as ten times more likely to develop it if you have a sufferer in the family compared with someone without. In identical twins where one has celiac disease the likelihood of the other developing it is around eighty percent.
In terms of environmental factors which activate the onset of celiac disease, a previous digestive tract infection and poor diet during early childhood can have an impact. Evidence suggests that introducing a diet containing gluten to babies younger than three months old can increase the risk of developing the disease. As a result, parents are advised to wait until the child is at least six months old before permitting gluten in the diet.
It is fairly normal for someone to have more than one autoimmune disease. So if someone already has an autoimmune disease such as type 1 diabetes the risk of celiac is higher. Other associated diseases include inflammation of the colon, thyroid disease, and neurological disorders such as epilepsy, a condition where those afflicted have repeated fits or seizures.
It is important to continue with gluten in the diet prior to and during the testing process to ensure that the results are accurate. Testing through less invasive methods has improved over the years. This means that the body is not cut or physically penetrated. Testing involves two steps with the first stage being a blood test and the second a gut biopsy to confirm the positive result of the first step.
In the first stage, your healthcare provider takes a blood sample and tests it for certain antibodies that would exist in the bloodstream of a celiac disease sufferer. The most common one tested for is called tissue transglutaminase (anti-tTG). If these antibodies are present then the individual would move forward to the next stage.
However there are some people who do have celiac disease but the tTG antibodies are not found in the blood. If the healthcare provider is certain that celiac disease is present, there are other antibodies to discover through testing.
In the second stage, the sample tissue which is called a biopsy is collected during a procedure called upper endoscopy. This is where a tiny flexible tube equipped with a light and cutting tool is inserted into the mouth and carefully passed down to the small intestine. A local anaesthetic is provided to the patient in order to numb and relax the throat. Once inside a small piece of tissue can be removed and examined under the microscope. A healthy intestine would have many finger like structures but for someone with celiac these fingers become flattened.
Once diagnosed with celiac a number of other tests would be conducted to determine the extent of the disease’s damage. These tests might include more blood tests for anaemia, the iron deficiency, as well as looking at vitamin or mineral levels. In some cases x-rays of the bones may be needed if the healthcare provider believes that the individual may have the onset of osteoporosis.