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Living With Celiac Disease

Testing For Celiac Disease

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While there is a variety of home tests, the medical community considers the best way to determine whether a person has celiac disease through physician prescribed testing – starting with a blood test followed by an intestinal biopsy. If these tests are inconclusive, there may also be gene testing.[i]

It is preferable to eat food with gluten for at least one month before testing. If not, there may not be enough antibodies to show up on a blood test.  NOTE: Be aware that just because you may test negative, does not mean that you will never get celiac disease.

  • Home tests: There are a variety of home test kits available to test for a reaction to gluten. However, they essentially only test reaction to the foods you have recently eaten. They should not be relied upon as determining for sure whether you have celiac disease.[ii] If you do not have a primary care physician, a home test can be a helpful tool to determine whether to contact a doctor or other health care professional.
  • A blood test: A blood test is normally given by your primary care physician. It looks for antibodies in the blood stream. If the antibodies are positive it indicates a high likelihood of the presence of celiac disease.[iii]
    • Genetic tests Genetic testing can determine your risk for celiac disease. People with celiac disease have genetic markers called HLA DO2 or HLA DQ 8. If you do not have one of these markers, you do not have celiac disease.
    • Blood tests You may hear about blood tests for celiac disease. The tests look for specific antibodies that the body produces when a person who is sensitive to gluten eats gluten. Blood tests have not been scientifically validated. Please keep in mind that celiac disease needs to be diagnosed clinically by a physician.
    • Intestinal biopsy: The gold standard for determining the presence of celiac disease is an intestinal biopsy.
      • Usually performed by a specialist known as a gastroenterologist (gastro-entero-ologist), the procedure is known as an endoscopy (pronounced en-dos-co-pee).
      • An endoscopy involves an instrument placed down your throat to the small intestine. It then clips samples.
      • As a general matter, adults are sedated before the test. Children are given anesthesia

NOTE: People have been known to forego testing for a variety of reasons – including because of the cost of testing (particularly for people without health insurance) or because they don’t know anyone in their family who has had celiac disease. These people use an elimination diet and just stop eating gluten – with the idea of waiting to see if that eliminates the symptoms they are experiencing. Please keep in mind that if you think this is the best route for you, do not eat “mostly” gluten-free. You can do damage to yourself that way. The treatment for celiac disease is to stop eating gluten entirely.



[i][i] https://www.webmd.com/digestive-disorders/celiac-disease/features/learning-to-live-with-celiac-disease#3 – 30% of population tests positive for the gene, but only 1% get celiac disease

 

[iii] Joseph Murray MD – Mayo clinic you tube video - https://www.youtube.com/watch?v=3v-9gUjYGxI&feature=emb_rel_pause





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