- Celiac disease is a lifelong condition that can occur at any age.
- It may present a wide range of symptoms.
- It is important to get tested, control the symptoms.
- If left untreated, it can cause some serious problems.
Do you suffer from diarrhea, bloating, and flatulence every time you eat gluten-rich food? It is a possibility that you’re suffering from Celiac disease. In this article we will explain how to get tested for celiac disease and why or who should do it.
Celiac is a serious autoimmune condition in which eating wheat, rye, or barley, can cause inflammations. And, this can damage the lining of the small intestine.
With more damage caused to the intestinal lining, you’ll face problems with nutrient absorption. If you leave the condition untreated, you can even get anemia, osteoporosis, and more. It can even set off other serious medical conditions.
Unfortunately, the symptoms of the Celiac disease might be too subtle or confused with those of other common conditions. Sometimes, this disease does not manifest itself as any symptom at all! But, you can prevent it from causing significant complications if you get tested and adopt a gluten-free lifestyle.
If you have Celiac disease, you may present with various symptoms. Some of it may seem completely unrelated, while others may be too subtle. In fact, you can call Celiac disease the clinical chameleon among autoimmune conditions.
Its presentations can be anything from diarrhea and malabsorption to depression and fatigue. Now, you have to remember that Celiac disease may concur with other conditions that are related to it. In that case, the symptoms will also coincide and overlap. Sometimes, there’s no symptom at all.
Further, experts have noticed that most patients show symptoms that don’t even meet the detection threshold. As a result, the disease often goes undiagnosed. The symptoms are often misdiagnosed, too. The two most common misdiagnoses are Irritable Bowel Syndrome and lactose intolerance.
There was a time everyone thought that Celiac disease only affects children, and its symptom is malabsorption. However, this idea has completely changed since the 1950s. It is among the lifelong disorders that affect people of Europe and the US most commonly.
Further, there’s no age limit for this. However, people in their forties and fifties get diagnosed with this condition most frequently. Interestingly, 60-70% of people diagnosed with this disease are women. It’s possible that their tendency to seek healthcare impacts this number.
But, the number of people who present no symptoms of Celiac disease is not a small number.
In fact, around 38% of people diagnosed with Celiac disease do not show any symptoms.
Now, that’s something to worry about, isn’t it?
The signs of the disease are not only varied but also quite unspecific. This results in making the prognosis of Celiac disease a challenge. In America alone, the number of people with this disease is assumed to be 3 million. But, you’ll be shocked to know that 95% of them are undiagnosed.
You must remember that you cannot leave this condition untreated. Otherwise, this disease can increase the chances of other serious conditions by around four times. You may develop various complications like bone disease, fertility problems, and more.
There are several tests that can diagnose Celiac disease. To show accurate results, you need to be on a diet that has gluten in it. Otherwise, the tests will not be able to gauge your body’s reaction to gluten.
The tTG-IgA Test
Whether you are a child or an adult, an accurate diagnosis of Celiac disease can be expected from the Tissue Transglutaminase IgA test, i.e., the tTg-IgA test. In this test, a blood sample is drawn to measure the number of antibodies that you’re generating.
The accuracy of this test is extremely high. It can diagnose nearly 98% of people who have Celiac disease and aren’t following a gluten-free diet.
And that’s not it. The sensitivity of this test is so high that the result will be negative in the case of nearly 95% of people who don’t have the disease. You can tell from this that the test can accurately reveal the presence – as well as the absence – of Celiac disease in a person. So, there is very little chance of misdiagnosis.
While this is considered to be more sensitive than any other test for the disease, the chance of a false negative or positive in the result cannot be eliminated completely.
Truth be told, there might be a very slim possibility that the test result would come back negative even if you have the disease. An extremely small percentage of false negatives have been observed.
There’s also a scarce possibility of the result showing positive even though you don’t have the disease. This may happen if you’re suffering from some other autoimmune condition that’s associated with Celiac disease.
Such related conditions may include thyroiditis, autoimmune liver conditions, Type-I diabetes, rheumatoid or psoriatic arthritis, or some heart problem.
As a means of double-checking the tTg-IgA test result and eliminating the possibility of false positives or negatives, you can undergo some other antibody tests, as well. You can also get your small intestine biopsied.
If a child is less than 2 years of age, then two other antibody tests will be required – the IgG and the Deamidated Gliadin IgA.
Your doctor may prescribe other blood tests that can diagnose Celiac disease. Take a look at the following –
1. EMA Test: The specificity of the IgA Endomysial Antibody test is considered to be nearly 100%. But, while it is more specific than other tests, its sensitivity is much lower than the tTG-IgA test. The percentage of people who don’t get a positive result in this test despite having the disease is 5-10%
In addition, this test is quite expensive. Also, this test needs to use the umbilical cord of a human being or the esophagus of a primate. So, unless the patient is suffering from a condition that is hard to diagnose, this test is usually not prescribed for the detection of Celiac disease.
2. Serum Level of Immunoglobulin Test: The total serum test helps to gauge the deficiency of Immunoglobulin A. This deficiency is a Celiac disease-related condition. It can lead to misdiagnosis when the EMA or tTG-IgA test report comes back negative because of it.
Around 2-3% of the Celiac disease patients suffer from such a deficiency of the IgA. This may indicate the possibility of other medical conditions. These may lead to intestinal villous atrophy. In the case of this deficiency, you may further have to take the tTG-IgG or the DGP test.
3. DGP IgA and IgG Tests: If you have an IgA deficiency, then the doctor will recommend the Deamidated gliadin peptide test as part of the screening process. This test is also recommended for those testing negative for the EMA or the tTg antibodies.
In some rare cases, Celiac disease patients may test negative for antibody detection. This can be understood when the symptoms continue, even though your test result is negative. If that happens, it is essential for you to consult a doctor immediately.
There are two other types of blood tests that can further help with the diagnosis of Celiac disease –
1. Serology Test: This test searches for the presence of antibody proteins in the blood. Certain types of antibodies in high levels in the blood are indicative of immune reactions to gluten.
2. Genetic Test: This test is to check the Human Leukocyte Antigens. The HLA-DQ2 serotype group and the HLA-DQ8 serotype can increase the risk of celiac disease.
If you get a positive test result for Celiac disease, your doctor might further recommend the following:
a. Endoscopy: In this test, a small camera attached to a tube is passed down the throat so that it can give a view of the small intestine. This method of upper endoscopy even retrieves some tissue samples for a biopsy on its way back up, so that the damage of the villi can be analyzed.
b. Capsule Endoscopy: The test will also give a view of the intestine with the help of a small camera. The only difference is that the device is wireless and is fitted to a small capsule that you’ll need to swallow. This camera takes a trip through the digestive tract, taking several pictures of the same.
c. Video Capsule Endoscopy: A step ahead from capsule endoscopy is VCE, which diagnoses Celiac disease with 98% sensitivity and 95% specificity. It is far more sensitive at the detection of macroscopic atrophies, compared to upper endoscopy. It also detects related complications better.
d. Serum I-FABP Test: This test is helpful in the detection of Celiac disease. I-FABP marks enteropathy caused by gluten in Celiac disease patients. In the case of cellular damages, the blood circulation system received the cytosolic protein. This is an indication of an unintended consumption of gluten.
e. Radiology: Radiology can help to detect certain abnormal conditions like the dilation of the small bowel, vascular changes, thickening of the wall, and more. These findings of the radiological test may help to confirm the presence of Celiac disease.
f. Skin Biopsy: On the off-chance that you’re suffering from dermatitis herpetiformis, a common Celiac disease-related condition, your doctor might prescribe skin biopsy. A sample of your skin tissue will be examined with the help of a microscope to draw a conclusion about your condition.
Celiac Disease Test for Children (Less than 3 Years)
Children who might have Celiac disease are usually diagnosed between 2 and 3 years of age unless they show symptoms before that. Besides the usual tTG-IgA test, children below 2 years are also prescribed the IgG and the Deamidated Gliadin IgA tests.
Usually, when children below the age of 3 years show symptoms of Celiac disease, antibody tests might not be able to lead to an accurate diagnosis. A genetic test might help to find the genes that can cause it. A pediatrician may suggest tests if a child suffers from diarrhea or growth stagnation.
Children show their first signs of Celiac disease only after they have consumed gluten-based cereals for a stretch of time. It is only after prolonged exposure to gluten that their body gives autoimmune responses to gluten. And, only then can such responses reflect in the results of the screening.
Adults, as well as children above three years of age, should get screened for the Celiac disease if they experience symptoms of the condition. If you have other associated autoimmune conditions, like Type-I Diabetes, autoimmune thyroiditis disease, Turner Syndrome, Down Syndrome, Williams syndrome, autoimmune liver problem, or IgA deficiency, you should get tested, too.
In 2015, the National Institute for Health and Care Excellence, i.e., NICE, published a guideline to help understand the conditions of getting screened for Celiac disease. Adults and children should get tested if they notice signs as mentioned below:
- Prolonged gastrointestinal problems with any reason
- Stagnation or delay of growth
- Excessive loss of weight
- Regular and severe canker sores
- Anemia (Folate or iron deficiency)
- Deficiency of VB-12
- Diabetes (Type-I)
- Autoimmune thyroiditis
- Irritable Bowel Syndrome
Since this condition can also be genetically inherited, you should be extra careful in case any of your first-degree relatives – like parents, siblings, or even children – have this condition. That’s because of your chances of getting the disease increase to 10%, while the risk is 1% among people who do not have close relatives suffering from Celiac disease.
Celiac disease affects more people than you probably imagine. Did you know that 1 in every 100 people have this condition? Sadly, a large number of people go undiagnosed. Think of the US. Only 500K people out of around 3 million are diagnosed.
Wondering why that is? One of the main reasons is that this condition is not easy to detect. This is because the patients present a wide range of symptoms. Do you know that there are 300 signs of this condition? This is because the effects of the disease may vary from one patient to the other.
As if that wasn’t enough, some of the symptoms may seem like the signs of other diseases. In some cases, there are no symptoms! But whether you display symptoms or not, Celiac disease can quietly damage your body and cause severe complications. So, here’s why you should get diagnosed:
- Proper diagnosis will help you understand your exact condition. Accordingly, you’ll know how vigilant you have to be by adopting a gluten-free lifestyle. Without a diagnosis, you may continue consuming gluten, worsening your condition
- If you start a gluten-free diet without any diagnosis, it will affect the result of your test. The exact condition will not show up in the screening, and you might relapse to a gluten-rich diet. So, you need to get tested properly first.
- If you leave your condition undiagnosed, and hence, fail to eliminate gluten from your plate, you can eventually develop more severe problems in different parts of the body. MS, fertility problems, diabetes, and cancers in the intestine are possible results of the disease when left untreated.
- You don’t need to be scared of the Celiac disease tests. With the tTG-IgA test, your condition will be easily detected. There are plenty of other tests, which you have already read about above. These tests will help you to transition to a gluten-free life quite smoothly
- Since this disease is genetic, you run the risk of getting it if your first-hand relatives have this autoimmune condition. So, getting tested will show if you carry the genes of this disease. This will further help you to be careful
- Did you know that America legally recognizes Celiac disease as a disability in America? This means if you can present a document written and signed by a licensed practitioner, confirming your condition, schools can accommodate your needs
- Have you been suffering from long-term ailments, with no explanation? Then, getting tested for the Celiac disease might finally give you some answers. Sometimes, symptoms for a long time go unnoticed or ignore
Remember that there is no specific treatment – either medical or surgical – to eradicate the disease or eliminate all symptoms completely. The only thing you can do to keep the symptoms under control and to prevent the disease from causing severe complications is to follow a gluten-free diet.
If you manage to stay away from gluten completely, then your stomach lining starts to heal. As a result, the problems associated with the consumption of gluten start to go away. This also means that for an accurate diagnosis, you must get tested before moving on to a gluten-free lifestyle.
If you eliminate gluten from your diet before getting tested, the test result will come back normal. The point of getting tested is to see how your body is reacting to gluten. It is only after proper diagnosis that you can steadily move towards a healthier lifestyle by taking the necessary steps.