Celiac disease

Should you be treated for celiac disease?

Maybe you’re one of the millions of Americans who suffers mild or even severe gastrointestinal distress. Perhaps someone in your family has been diagnosed with celiac disease and you have been told you should be tested too. Or maybe you’ve heard how common celiac disease is, and that it can occur in people with minimal symptoms. Also, people who go undiagnosed can develop a variety of related symptoms.

How do you get tested for celiac disease, and how do you know for sure that you are getting quality testing? Do you need to be tested even if you don’t have symptoms of celiac disease? The answers to these important questions may change your life, since they could be the keys to your health and well-being.

What is celiac disease?

Celiac disease is a common genetic intolerance to gluten. Gluten is found in wheat, rye, barley, and other grain products. People with celiac disease must strictly avoid these foods for the rest of their lives. Fortunately, the gluten-free diet is extremely healthy, and there are many excellent sources of gluten-free products.

Celiac disease is common, yet many people haven’t even heard of it, and most who have it don’t know it. Studies show that celiac disease may occur in 1 in 133 “healthy” people. It may be as common as 1 in 40 people who have symptoms. Celiac disease may be the most common genetic disorder in the U.S. and the world.

Classic symptoms are gastrointestinal in nature such as gas bloating, diarrhea, or constipation. Yet many people don’t have these classic symptoms; instead the have what is referred to as “atypical symptoms”, which include fatigue (due to unexplained anemia), infertility, osteoporosis, joint pain, reflux, headaches, and the presence of other autoimmune condition. Some people have no symptoms at all.

Who should be tested for celiac disease?

  • Anyone who has classic symptoms of gastrointestinal distress
  • Family members of people diagnosed with celiac disease
  • People who have been tested before and whose results were inconclusive
  • Individuals that may carry a higher risk of celiac disease: Type 1 diabetes, osteoporosis, anemia, Down’s Syndrome, cystic fibrosis, and autoimmune disease

How is celiac disease diagnosed?

Celiac disease is an autoimmune condition, which means that the body initiates an attack against itself in response to a “trigger.” In the case of celiac disease, the trigger is gluten, and the part of the body under attack is the small intestine.

When this attack is launched, the immune system produces antibodies. These antibodies are called “anti-gliadin, ” and “anti-endomysial” and, “anti-tissue transglutaminase.”

There are two steps to diagnosing celiac disease. The first is a blood test that measures the antibodies mentioned above. If antibody levels are high, it is very likely that celiac disease is present, and the diagnosis is confirmed by doing an intestinal biopsy to see if damage has been done to the small intestine and to rule out the possibility of other conditions.

How do I get tested?

In order to be tested for celiac disease, you must be on a gluten-containing diet, preferably for at least three to six months. If there is a little or no gluten in your diet, your anti-body levels will be low, even if you do have celiac disease. A false negative could occur.

Your primary care provider can order the blood tests. But generally, if you have gastrointestinal symptoms, you will be referred to a gastroenterologist who will order the tests.

While blood for the antibody testing can be drawn at any lab, the facility where the testing is done is extremely important. You should make sure test includes a complete celiac antibody screen, which includes:

  • Anti-Gliadin (AGA) IgA
  • Anti-Gliadin (AGA) IgG
  • Anti-Endomysial (EMA) IgA
  • Anti-Tissue Tranglutaminase (tTG)
  • Total Serum IgA

You can ask that your blood sample be sent to a specialty lab for testing. Check with your insurance company for information regarding coverage of the tests.

What if the results of my antibody screening are positive?

If the results of your antibody screening are positive, you may need an intestinal biopsy to determine the extent of damage, if any, to your small intestine.

If you are diagnosed with celiac disease, the recommended treatment is to adopt a gluten-free lifestyle. Besides being found in some grains, gluten can also be hidden in ingredients such as modified food starch, hydrolyzed vegetable protein, and other additives. It is important to maintain a gluten-free diet, because small amounts of gluten can have harmful effects. Newly diagnosed individuals with celiac disease who go a gluten-free diet can expect to see improvement in their health each day.

The diagnosis of celiac disease may seem difficult at first and to be truthful, it is. But the sooner your are diagnosed, the sooner you can take steps to manage your disease. In the United States, the average length of time between the onset of symptoms and diagnosis of celiac disease is ten years.