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

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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.

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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.

A team of researchers recently set out to assess the positive predictive value of blood test screening for possible cases of celiac disease.

A team of researchers recently conducted a systematic review of diagnostic testing for celiac disease among patients with abdominal symptoms.

Tina Turbin describes the recent research indicating an association between irritable bowel syndrome and celiac disease. She describes celiac disease and gluten intolerance and the treatment, a gluten-free diet. She also sets down some of the benefits of increased celiac awareness and support for the gluten-free community.

A team of researchers affiliated with the South-Eastern Norway Regional Health Authority and the University of Oslo is conducting a clinical trial to evaluate the use of HLA-DQ2-gliadin tetramer for diagnosing celiac disease. Their study will assess the use of HLA-DQ2-gliadin tetramer for staining gluten specific T cells to effectively diagnose uncertain celiac disease.

New Blood Tests for Celiac Disease

A research team set out to determine the usefulness of newer assays incorporating synthetic deamidated gliadin-related peptides (DGPs), or other TG isoenzymes as antigen, for detecting gluten sensitivity in IgA anti-tTG–seronegative patients.

A group of clinicians recently set out to estimate the rate of mucosal recovery under a gluten-free diet in adult subjects with celiac disease, and to gauge the clinical prospects of ongoing mucosal damage in celiac patients following a gluten-free diet.

Mass screening studies among the general population for celiac disease show a prevalence of approximately 0.5-1.0% in adults and in children. Yet, despite the growing numbers of newly diagnosed celiac disease patients, most cases still remain undiagnosed and therefore, untreated. In part, the masses of misdiagnosed or undiagnosed  celiac disease  patients are a result of the variety of disguises  celiac disease can have. Celiac disease can manifest into a multitude of symptoms including, but by no means exclusive to, malabsorption syndrome, diarrhea, anemia, infertility and osteoporosis.

A team of researchers recently compared the technical performance and accuracy (sensitivity and specificity) of commercial IgG anti-DGP assays from Euroimmun, Inova, Phadia and The Binding Site against other serologic assays for celiac disease, such as 3IgA and 2IgG anti-tTG assays, 1IgA and 1IgG anti-gliadin assay, 1IgA anti-DGP assay.

Many people are confused about which tests provide the most accurate results for a celiac diagnosis. In a recent study by a team at the Department of Gastroenternology and Internal Medicine, St. Orsola-Malpigihi Hospital, University of Bologna, Bologna, Italy, researchers evaluated  current testing methods, and made some conclusions about celiac testing that may shed light on the subject for those of us overwhelmed by current conflicting information.

A team of researchers recently set out to study the viability of confirming histological evidence of villous atrophy in real time, during upper gastrointestinal endoscopy, in live duodenal mucosa of patients with celiac disease, using endocytoscopy, a novel diagnostic technique allowing in vivo real-time visualization of mucosa under 450x magnification.