Getting Tested for Celiac Disease and How It's Treated

Woman holding her stomach in pain

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What Is Celiac Disease?

Celiac disease is a hereditary autoimmune disease in which consuming gluten leads to damage in your small intestine.

When someone with celiac disease eats gluten, the body will attack the small intestine. Consequently, nutrients can’t get properly absorbed into the body, and this can cause a number of health issues.

Gluten

Gluten is the name for a family of proteins found in wheat (e.g., durum, semolina, farro, wheatberries, and spelt), rye, barley, and triticale. Gluten allows food like bread loaves to form and maintain their stiff shape.

The protein acts as a type of glue to hold up wheat-based products that you find populating restaurants, grocery stores, and your own kitchen.

Although you might think gluten is found mostly in bread, these proteins are commonly found in a number of food products. This presents a significant dietary challenge to anyone experiencing gluten intolerance.

Where Gluten Is Found

According to the Celiac Disease Foundation, you can find gluten in the "big three" foods:

  • Wheat
  • Barley
  • Rye

You can also find gluten in oats and triticale, a new grain grown to offer a similar taste and texture of wheat.

Foods often containing gluten include the following:

  • Breads
  • Bakery items (e.g., muffins, cinnamon rolls, bagels, and cookies)
  • Soups
  • Pasta (e.g., raviolis, couscous, and gnocchi)
  • Salad dressings
  • Boxed cereals
  • Alcoholic beverages (e.g., beer that contains malt)
  • Malt milkshakes
  • Food colorings

Getting Tested

Anyone can get tested if they meet any of the following three criteria, according to the Celiac Disease Foundation:

Children

If your child is three years of age and older and are experiencing symptoms of Celiac disease then you can get tested: These symptoms include:

  • Anemia
  • Digestive symptoms
  • Abdominal bloating and pain
  • Constipation
  • Weight loss
  • Fatigue
  • Behavioral issues

Adults

Adults are less likely to have digestive symptoms, but could experience any of the following:

  • Migraines
  • Fatigue
  • Joint Pain
  • Depression
  • Seizures
  • Irregular menstrual cycles

You should also get tested for Celiac disease if any of the following are true:

  1. You have a first-degree relative with celiac disease, such as a parent or a sibling. This is important to know because this disease is passed on through genetics.
  2. You have an associated autoimmune disorder, such as type 1 diabetes, Down syndrome, Turner syndrome, Williams Syndrome or immunoglobin A (IgA) deficiency.

If you have a gluten sensitivity, you are out of luck with testing for it. According to Beyond Celiac, a patient advocacy, research-driven organization, you can’t get an accurate test for a gluten sensitivity.

You won’t find reliable tests on the market at this time. You might find doctors who offer saliva, blood or stool testing, but these tests aren’t validated and won't provide anything of value. 

Types of Testing

The Celiac Disease Foundation says the most appropriate way to test for celiac disease is to start with taking an IgA antibody test. If you are fit for further tesiting, blood tests can be conducted.

Antibody Testing

An IgA antibody test will ensure you generate enough of this antibody for an accurate celiac disease test result, which is especially important if you have an autoimmune disorder because you run the risk of showing a false positive.

The Gluten Challenge

If you currently follow a gluten-free diet, your medical professional also might suggest allowing antibodies to build up in your bloodstream before you conduct any test. Should your doctor prefer you do this, the recommended gluten intake is two slices of wheat-based bread each day for six to eight weeks.

You must be supervised by your doctor in case your symptoms become severe. (This test is known in the medical world as The Gluten Challenge.)

Blood Testing

Once your doctor determines you are fit for testing, you move on to step two, blood testing.

One of the most accurate blood tests for celiac disease is the tTG-IgA Test, known for its simplicity, wide availability, and the fact that it’s typically covered by insurance. Other blood tests your health care professional might administer instead include a total IgA or IgA-EMGA.

If You Get a Positive Result

If the test comes back positive, your medical professional will most likely suggest a biopsy of the lining of your small intestine to confirm that it is in fact celiac disease.

You must be on a gluten-containing diet at the time of the biopsy, and although this procedure might sound like a big deal, you should finish in approximately 15 minutes. The procedure is considered low risk.

Because of the damage celiac disease can do to the small intestine, you should get laboratory tests done within three to six months following a positive test result, and again annually for the rest of your life to ensure you aren’t deficient in necessary vitamins and minerals.

If You Get a Negative Result

If the test comes back negative, you could still have celiac disease (although the chance remains quite small). For anyone still experiencing severe symptoms after a negative diagnosis, you should talk to your doctor about other tests you can take. These include a biopsy of your small intestine’s lining or genetic screenings.

Getting Tested When The Doctor is Doubtful

You can still get tested if you have trouble convincing a doctor that you might have celiac disease.

According to Beyond Celiac, you can conduct your own at-home with a product from the organization Imaware. They have created a comprehensive test you administer to yourself. The test looks at four biomarkers, including tTG. The only limitation is that you must be 18 years or older to take the test. 

Treatment for Celiac Disease

For those who received a positive diagnosis for celiac disease, the only treatment available is to follow a strict gluten-free lifestyle.

This includes avoiding all foods containing even trace amounts of gluten and vigilantly reading ingredient labels.

Sometimes wheat, barley, and rye are listed under different names. When it comes to celiac disease, you need to be an educated consumer to keep your diet under control. If something is not listed as being gluten-free you will need to look at labels carefully.

According to the Celiac Disease Foundation, look for the following on labels so you can avoid them:

  • Barley
  • Wheat
  • Farina
  • Semonlina
  • Rye
  • Spelt
  • Triticale
  • Graham flour

You can even find gluten in some of these unexpected products:

  • Candy bars
  • Salad dressings
  • Cosmetics (e.g., lipgloss, lipstick, lip balm—these may be ingested since they are used close to the mouth)
  • Nutritional supplements
  • Vitamins
  • Play-dough (children may ingest this)
  • Dental care products

As your best bet, you should strongly consider working with a registered dietician on creating a healthy, gluten-free diet.

Also, since many products are listed and gluten-free, it can be easier to shop for foods that can be safe for you diet.

According to an October 2017 study from the World Journal of Gastroenterology, the food industry has development gluten-free products with 2014 sales approaching $1 billion and sales estimations of $2 billion by 2020.

Healing

Once starting on a stringent gluten-free diet, your small intestine should start to heal. Complete healing in adults can take many years; children take six months or less.

If you have severe damage to your small intestine, your doctor might prescribe steroids to help with inflammation and reduce your pain. Other drugs such as azathioprine or budesonide could be used as well.

Statistics on Gluten Intolerance

Celiac disease doesn’t discriminate as men and women of all ages and races can be diagnosed with celiac disease.The World Journal of Gastroenterology study says that 1 percent of the population has Celiac Disease, which is about 1 in 133 Americans, and 6 percent has some type of non-Celiac gluten sensitivity.

But according to Beyond Celiac, 83% of Americans with celiac disease are either undiagnosed or misdiagnosed with other conditions, and people wait six to 10 years to be correctly diagnosed. In addition, throughout a four-year period, people living with undiagnosed celiac disease spend an average of almost $4,000 more than those living without celiac.

This doesn’t need to be the case. Because of the ease of at-home tests, you can easily discover if you have this autoimmune disease and be on your way to treatment and healing.

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Article Sources
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