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Diagnosing Celiac Disease

Posted Jan 17 2010 3:08am


Celiac disease is a known disease of the small intestine. With celiac disease, the intestine experiences an immunological or allergic reaction. The small intestine does not absorb the nutrients of the food digested. This leads to nutritional, vitamin and mineral deficiencies. Diagnosing celiac disease early is very important to prevent any critical illness.

Celiac disease is common in European countries, particularly in Ireland, Italy, Sweden and Austria. In Finland, the prevalence may be as high as one in every 100 persons. While in North America, its prevalence is one in every 3000 people. Worldwide, its occurrence would be one in every 250 people.

Its exact cause is unknown but it is often inherited. If someone in the immediate family has it, chances are 5 percent to 15 percent that the member of the family may have it as well. It can occur at any age, although problems don’t appear until gluten is introduced into the diet.

There are also times, for unclear reasons, that the disease appear or was experienced after some form of trauma. It can happen or emerge after an infection, a physical injury, the stress of pregnancy, severe stress or surgery.

There are no typical signs and symptoms of celiac disease and there are even patients that have no symptoms. They only show the symptoms after inducing or introducing gluten into their diet. There are cases that celiac disease is misdiagnosed or undiagnosed. The symptoms are often confused with other conditions, like irritable bowel syndrome, gastric ulcers, or nervous conditions.

Blood tests are conducted such as anti-tissue translutaminase and anti-endomysial antibodies. Blood tests are used to find the elevated antibody levels. These elevated levels are a sign of celiac disease, since the person’s immune system recognizes gluten as a foreign substance and increases the number of antibodies to fight it.

After confirming or getting elevated antibody levels in the blood tests, the doctor or attending physician perform intestinal tissue checks. This is to microscopically examine a small portion of intestinal tissue to check for damage to the villi.

A thin, flexible tube is inserted through the mouth, esophagus and stomach and into the small intestine to take a small tissue sample. The tiny, hairlike projections from the small intestine that absorb vitamins, minerals and other nutrients will provide the necessary information if the villi is damaged.

Also, patients with celiac disease show other clues. Patients may have the presence of a blistering, itchy skin rash known as dermatitis herpetiformis. An estimated 10 percent of patients with celiac disease also have this skin disorder. Dermatitis herpetiformis is a skin disease that can be found on the extremities, buttocks, neck, trunk, and scalp.

After undergoing medical examinations, a trial of a gluten-free diet can confirm the diagnosis. But before undergoing the gluten-free diet, medical evaluation is required. Undergoing the diet may have an impact on the results of the blood test and biopsies. They may appear normal and without any complications even if the patient is positive with celiac disease.

Dennis Lee, M.D, the author of the article “Celiac Disease(Gluten Enteropathy)” states that it is necessary to firmly establish the diagnosis of celiac disease before commencing to gluten free diet for three main reasons: (1) to identify the gluten-free diet should be followed which is a life-long and tedious commitment; (2) to avoid patients with irritable bowel syndrome (IBS) to unnecessarily commit to life-long gluten restriction; and (3) a gluten free diet can lower the blood antibody levels and allow the small intestine to lose the typical appearance of celiac disease, complicating subsequent efforts at making a firm diagnosis of celiac disease.

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