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Celiac Disease Diagnosis, Testing & Treatment (Gluten-Free Diet)

This category contains a comprehensive overview that covers the information on diagnosing and treating celiac disease, including the latest research on the various new tests/screening techniques.
Note: The only medically acceptable treatment for celiac disease is a 100% gluten-free diet for life.

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    Photo: CC - timbrauhn
    anti-tTg levels at least 5x the upper limit of normal are sufficient to diagnose celiac even in adults; a biopsy is unnecessary.


    Photo: CC-R/DV/RS
    A company called Microtest Laboratories is manufacturing doses of what they claim may be the first effective vaccine treatment for celiac disease. At this point, the only treatment for celiac disease is to avoid gluten in the diet.


    Photo: CC - milos milosevic
    Detecting gluten sensitivity early in individuals can have major health benefits, preventing not only the development of celiac disease (that is, villous atrophy, according to Dr. Fine), but a wide array of autoimmune diseases and conditions such as osteoporosis, malnutrition, infertility, certain mental disorders, and even some forms of cancer.


    Photo: CC--MPClemens
    In an effort to understand how delayed celiac disease diagnosis became the norm for most patients over the last few decades, a research team conducted a study to assess the issue. Their study also looked at how delayed diagnosis affects health-related quality of life (HRQoL) for those with celiac disease, and considered differences with respect to sex and age.


    Photo: CC--Muffet
    A research team recently assessed variability in small bowel histopathology reporting between different pathology practice settings, and its impact celiac disease diagnosis.


    Photo: CC - spec-ta-cles
    Non-controlled studies suggest that Rifaximin may improve celiac disease symptoms in such cases. However, up to now, no controlled trials have been conducted.


    Photo: CC- Spirit-Fire
    Villous atrophy may be present only in the duodenal bulb, so a biopsy of this region should always be including when diagnosing celiac disease.

    A team of researchers set out to assess the clinical, pathological and serological spectrum of celiac disease in a general population via prospective study (Kalixanda study).


    Adherence to biopsy guidelines recommended by the AGA in 2006 - that at least four samples be submitted - doubles the probability of a celiac diagnosis.


    New research on using HLA-DQ2-gliadin tetramer test to detect celiac disease.
    In an effort to improve diagnosis of celiac disease in patients already on a gluten-free diet, a team of researchers recently evaluated HLA-DQ2-gliadin tetramers for detection of gluten-specific T cells in peripheral blood and histological changes in the duodenum after a short gluten challenge as a diagnostic tool.


    Photo-CC-aldenchadwick_thumb.jpg
    Question:  Do I have to re-introduce gluten in order to have an accurate gluten sensitivity test done?  Answer: Yes and No.  If a person knows they are sensitive to gluten and have gone on a
     gluten-free diet, and want to know if they can have gluten again, then a challenge is in order (reintroduce gluten).


    Tina Turbin is an author, researcher, and gluten-free advocate.
    As an author, researcher, and gluten-free advocate, I work hard to raise awareness for celiac disease and gluten issues, particularly when it comes to increasing the diagnosis rate. Part and parcel of improving diagnosis is proper testing. Evidence is mounting that indicates that blood testing may not be the most effective way to test for celiac disease, and I would recommend that people who suspect they have celiac disease to check with their doctors about other testing options.


    New celiac saliva screening study in JPGN.
    Driven by the high prevalence of celiac disease, a team of researchers based in Italy to assess a new, noninvasive disease screening strategy that would allow them to make an early diagnosis of celiac disease in 6- to 8-year-old children.


    New American Journal of Gastroenterology paper examines celiac disease prevention measures.
    A team of researchers recently compiled an overview of prevention measures and exploratory pharmacological treatments of celiac disease. Maud Pinier, Gregor Fuhrmann, Elena Verdu and Jean-Christophe Leroux comprised the research team.


    Important new FDA approval of celiac disease testing.
    The US Food and Drug Administration (FDA) has given 510(k) clearance for the first two fully automated gliadin tests featuring deamidated peptides for celiac disease. That means U.S. doctors and patients looking for accurate early diagnosis of celiac disease now have a state of the art celiac disease assay with both a high level of sensitivity and specificity.


    Photo: CC/Tandemracer
    Serological screening of healthy volunteers from around the world estimates that the prevalence for celiac disease is approximately 0.5%- 1% of the total population. However, a recent meta-analysis denotes that the actual ratio of known or undiagnosed celiac cases is closer to 1 in 7 people.


    Blood tests miss in some symptomatic kids.
    Properly diagnosing children with celiac disease in conditions where there may be environmental or other causes for classic celiac-associated symptoms, such as malnutrition, diarrhea, and failure to thrive, can present challenges to clinicians.


    Monkey Esphagus (photo courtesy of travlinman43)
    Scientists have previously seen a nuclear fluorescence reactivity (NFR) pattern on monkey esophagus in sections which were exposed to celiac disease patients that were sera positive for anti-endomysium antibodies (EMA). Because of this prior knowledge, scientists created a new study to illustrate the NFR, to study  NFR positive results in connection with gluten withdrawal, and also to assess  the possible role if NFR in celiac disease follow-up's.


    Columbia University--Photo: CC/Stijn Debrouwere
    A team of researchers evaluated the possibility of diagnosing celiac disease using quantitative analysis of videocapsule endoscopy images.


    Alessio Fasano, M.D. (photo courtesy of University of Maryland)
    In my work as an author, researcher, and gluten-free advocate, I strive to raise awareness for celiac disease and gluten intolerance because I know that with increased awareness will come more research, more proper diagnoses, and even improved treatment. Illustrating this, studies linking the onset of celiac disease to changes in microbes in the digestive tract are not only addressing the question of delayed onset, but they may lead to new research that could eventually result in a probiotic treatment for celiacs.

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