Did you know that many people suffer from celiac condition without knowing it? Many studies indicate that only one in five people who suffer from the disease actually prove that they have it. If you want to find out if you have celiac condition, find out what the tests are to find out if you have celiac condition and what to look out for.
Why is it important to detect celiac condition?
Detecting celiac condition is very important, because if you don’t know you have the disease, your intestine may be slowly being damaged without you even knowing it. Symptoms can vary significantly from person to person, so this also makes it difficult to get the correct diagnosis if the right tests are not carried out.
With a blood test it is possible to detect celiac condition, as people who have the condition and eat gluten have a higher level of certain antibodies in their blood. This increase in antibodies is produced by our immune system when the body registers the presence of gluten (the proteins found in wheat, rye and barley) and takes it as a threat.
Celiac condition tends to run in families, so if you have a parent, child, brother or sister with the condition, be aware that it is key to consider this and discuss it with your doctor. Celiac condition is also generally considered to be more common in people with type 1 diabetes, autoimmune liver disease, thyroid disease, Down’s syndrome, Turner’s syndrome or Williams syndrome. So, if you have any of these conditions, you can ask your doctor if you need to be tested for celiac condition.
Before testing
If your doctor says so, you should undergo appropriate tests for detecting coeliac disease. As the aim is to detect antibodies, you will need to include some gluten in your diet for the tests to be accurate.
If your usual diet is gluten-reduced, your doctor may suggest consuming something to run these tests. How much should you eat? If you eat two servings of gluten for at least eight weeks, the antibody tests will be accurate. Remember that it is essential that a professional is the one who gives you this recommendation.
Who should be tested?
Let us look at all the cases in which tests for celiac condition may be requested:
In children over 3 years of age and adults experiencing symptoms of celiac condition.
First-degree relatives of people with celiac condition: parents, siblings and children have a 10% risk, compared to 1% in the general population.
Any individual with an associated autoimmune disorder or other condition. Especially type 1 diabetes mellitus, autoimmune thyroid disease, autoimmune liver disease, Down’s syndrome, Turner’s syndrome, Williams syndrome and selective immunoglobulin A (IgA) deficiency.
Celiac condition in children
Generally speaking, children at risk of celiac condition are not screened until they are two or three years old, unless symptoms appear before this age. This is because in children under three years of age, antibody tests may not always be accurate.
It is estimated that children need to eat wheat or barley-based cereals for some time, up to a year, before they can generate an autoimmune response to gluten that can be detected by testing. In these cases, a paediatric gastroenterologist should be the one to examine young children experiencing stunted growth or persistent diarrhoea for celiac condition.
It is important to consider that while a genetic test alone cannot diagnose celiac condition, it may be able to rule out celiac condition if none of the genes are present and can be performed at any age.
Tests: which ones should be done?
tTG-IgA test
For most children and adults, the best way to test for celiac condition is with the IgA antibody to tissue transglutaminase plus an IgA antibody to ensure that the patient generates enough of this antibody. In this way, the celiac condition will be accurate.
For young children (around 2 years of age or younger), IgA and IgG antibodies against deamidated gliadin should also be included. As mentioned above, all blood tests for celiac disease require the patient to follow a gluten-containing diet for best and greatest effectiveness.
The tTG-IgA test will be positive in approximately 98% of patients with celiac condition who are on a gluten-containing diet.
HLA genetic testing
This study looks for the HLA-DQ2 and HLA-DQ8 genes. If the patient does not have them, it is very unlikely that he/she has celiac condition. You may have a blood test, a saliva test or a swab of the inside of your cheek.
It is important to note that there is also a slight risk of a false positive test result, especially for people with associated autoimmune disorders such as type 1 diabetes, autoimmune liver disease, Hashimoto’s thyroiditis, psoriatic or rheumatoid arthritis and heart failure.
These tests are not sufficient to prove that a person has celiac condition, but if the results indicate that the patient might have celiac disease, the next step should be endoscopy.
Video Capsule Endoscopy (VCE)
ECV has a sensitivity of 89% and a specificity of 95% for the diagnosis of celiac condition. This test method is more sensitive in detecting macroscopic atrophies compared to regular digestive endoscopy, which is also performed in these cases.
This procedure allows the doctor to check the small intestine for damage. To do this, they will insert an endoscope with a camera through the mouth. It will travel down the oesophagus and into the intestinal tract. The doctor will probably take some tissue from the lining of the small intestine to study it further. Doctors call this a biopsy.
Detecting celiac disease is very important and something that must be discovered early. If you have any questions, you can contact us here. At Ambar we perform clinical reference analyses and manage them to be integrated in an agile and flexible way. If you are a centre looking to outsource these analyses, you can leave us your message by sending us this message form.
