Celiac Disease Diagnosis
Celiac is autoimmune
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Celiac disease: When the body goes against the grain -Diagnosis
In a person with celiac disease, gluten produces higher-than-normal levels of two antibodies: anti-tissue transglutaminase (tTG-IgA) and antiendomysium (EmA-IgA). The tTG-IgA screening test is the most sensitive; it identifies people who are at risk for celiac disease even if they have no symptoms. If you test positive for these antibodies, Dr. Kelly and other experts strongly recommend that you undergo a small-bowel biopsy to confirm the diagnosis. (The biopsy is a relatively simple procedure performed under local anesthesia.) Damage to the lining verifies the presence of celiac disease. Knowing for certain is critical because the treatment-- following a gluten-free diet for a lifetime -- can be challenging and costly.
Doctors strongly discourage people from trying a gluten-free diet on their own before receiving a firm diagnosis. That's because the antibody tests are accurate only if you are eating gluten-containing foods.
Who should be tested?
People with recurring, unexplained gastrointestinal symptoms such as pain, bloating, or diarrhea should consider testing for celiac disease. Iron-deficiency anemia or high levels of certain liver enzymes (transaminases) should raise a red flag, as should unexplained, recurrent miscarriages and infertility.
Women who develop osteoporosis early (before menopause) or whose osteoporosis suddenly worsens should also consider the possibility of celiac disease. One small study reported a 17-fold higher incidence of the disease among women with osteoporosis compared to women in the general population. Some doctors recommend that parents, siblings, and children of people with celiac disease undergo testing because 5%-15% of first-degree relatives of an affected person are likely to have the disease, too.