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  • Scott Adams
    Scott Adams

    Celiac Disease Screening

    Reviewed and edited by a celiac disease expert.

      What's involved in screening and testing for celiac disease? Here are the basics of celiac screening.


    Caption: Image: CC--Free Images

    Celiac.com 03/05/2019 - Doctors commonly suggest celiac screening for anyone with a family history of celiac disease, or of disorders such as thyroid disease, anemia of unknown cause, type I diabetes or other immune disorders or Downs syndrome. Otherwise, patients are generally screened on a case by case basis according to individual symptoms.

    Genetic Testing

    Celiac disease is influenced, but not determined, by genetics. That means that susceptibility to celiac disease can be inherited, but the disease itself is not inherited. At least two genes, HLA-DQ2, HLA-DQ8, play a major role in celiac disease susceptibility. About 95% of people with celiac disease have the HLA-DQ2 gene and most of the remaining 5% have the HLA-DQ8 gene. A number of genetic testing services can tell you whether you have these genes. Some will test specifically for celiac genetics, others will test for celiac genetics as part of a general test. Genetic testing can help to indicate whether you might have a greater risk for celiac disease.

    Antibodies Point to Celiac Disease

    People with celiac disease have abnormally high levels of associated antibodies, including one or more of the following: anti-gliadin, anti-endomysium and anti-tissue transglutaminase, and damage to the villi (shortening and villous flattening) in the lamina propria and crypt regions of their intestines when they eat specific food-grain antigens (toxic amino acid sequences) that are found in wheat, rye, and barley. Antibodies are the specialized proteins the immune system uses to break down and eliminate foreign substances from the body. In people with celiac disease, the immune system treats gluten as a foreign invader and produces elevated levels of antibodies to get rid of it, causing symptoms and associated discomfort.

    Testing for Celiac Antibodies

    A blood test, such as anti-tissue transglutaminase and anti-endomysial antibodies, can detect abnormally high antibody levels, and is often used in the initial detection of celiac in people who are most likely to have the disease, and for those who may need further evaluation. Since the immune system of a person with celiac treats gluten as a foreign substance and increases the number of antibodies, elevated levels of these antibodies are a sign of celiac disease.

    Clinical Celiac Testing

    Typically, initial blood screening for celiac disease is done at a doctor’s office or at a clinic. Typically, such tests are ordered by a physician for patients who show symptoms, and/or a family history of celiac disease. If the results are positive, doctors will usually seek to confirm the diagnosis with a biopsy.

    Home Test Kits for Celiac Disease

    In the last several years, a number of accurate, reliable home test kits for celiac disease have come onto the market. Some of these kits deliver quick results in the home, while others require the consumer to mail the sample to a lab and receive the results later. Some mail-in kits use the same tests and labs as clinics do.
     
    Home test kits can offer convenience, confidentiality, and savings to consumers. They can also provide confidence for people, with or without symptoms, who believe they may have celiac disease. It’s not a good idea to use home test kits to diagnose celiac disease. As with clinical test results, positive results from home test kits should be confirmed by a doctor, and proper diagnosis and care should be initiated. 

    Confirming Celiac Diagnosis

    To confirm a diagnosis of celiac disease, your doctor will likely want to do a biopsy. That’s where they visually examine a the small intestine to check for celiac-related damage. To do this, your doctor inserts an endoscope, a thin flexible tube, through your mouth, esophagus and stomach into your small intestine. The doctor then takes a sample of intestinal tissue to look for damage to the villi, the tiny, hair-like projections in the walls of the small intestine that absorb vitamins, minerals and other nutrients. If the biopsy shows celiac-associated damage, the doctor will confirm the diagnosis and encourage you to adopt a gluten-free diet.

    Edited by Scott Adams


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    I was diagnosed with Multiple Sclerosis in 1993 and I'm a R.N. who became disabled unable to continue working and I was put on SSDI. I got divorced and then re-married in 2001. My step-son HAS AUTISM and my husband is diagnosed with ADD. So I read Dr. Shari Lieberman's book and I decided to start my family on a Diary Free and a GLUTEN-Free Diet. I was a Dietian Major before. I was a Nursing Major in College. So I have had this interest in diets and how they affects us. So we have taken out dairy products already. So just need to add Gluten to things to remove from our diet. Ive removed sugar and chocolate already because of it's affect it had on me. Thank You for your time. I'm always open for suggestions.

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    I believe the serum test and the biopsy to give many false negatives. There is a new test designed by Dr. Harry Delcher in Atlanta GA that is quite accurate. I believe it to measure antibodies in a stool sample.

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    Did you say the stool test is or isn't accurate. We just ordered the test kit for $394 for Enterolabs and would like to know if this is a valid method of testing.

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    Did you say the stool test is or isn't accurate. We just ordered the test kit for $394 for Enterolabs and would like to know if this is a valid method of testing.

    Enterolab is excellent & a valid method. As stated above " A blood test, such as anti-tissue transglutaminase and anti-endomysial antibodies, can detect abnormally high antibody levels, and is often used in the initial detection of celiac." Unfortunately, blood test may miss up to 70% of gluten sensitivities & an invasive biopsy is almost always uncalled for because DNA gene testing can confirm results. If one has the Celiac sprue gene or 1 or 2 gluten sensitivity genes from their parents & are experiencing an autoimmune response to their sensitivity they most likely have damage in the small intestine. A Biopsy only tells on how much damage; why bother with an invasive procedure when it is not needed! You need to stop the damage ASAP & go gluten free.

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    Enterolab is excellent & a valid method. As stated above " A blood test, such as anti-tissue transglutaminase and anti-endomysial antibodies, can detect abnormally high antibody levels, and is often used in the initial detection of celiac." Unfortunately, blood test may miss up to 70% of gluten sensitivities & an invasive biopsy is almost always uncalled for because DNA gene testing can confirm results. If one has the Celiac sprue gene or 1 or 2 gluten sensitivity genes from their parents & are experiencing an autoimmune response to their sensitivity they most likely have damage in the small intestine. A Biopsy only tells on how much damage; why bother with an invasive procedure when it is not needed! You need to stop the damage ASAP & go gluten free.

    My daughter had the blood test and tested negative. She did have a gene for celiac sprue and one for gluten sensitivity on DNA testing. On stool testing, she was found sensitive to wheat. She then had a food panel done, but had been on a gluten free diet for two months and again tested negative for a wheat allergy. I am getting confused on what constitutes a "good" test for this condition.

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    My daughter had the blood test and tested negative. She did have a gene for celiac sprue and one for gluten sensitivity on DNA testing. On stool testing, she was found sensitive to wheat. She then had a food panel done, but had been on a gluten free diet for two months and again tested negative for a wheat allergy. I am getting confused on what constitutes a "good" test for this condition.

    I was told from my doctor that you can't be practicing a gluten-free diet before your tests prognosis because it will decrease the levels of your natural antibodies.

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  • About Me

    Celiac.com's Founder and CEO, Scott was diagnosed with celiac disease  in 1994, and, due to the nearly total lack of information available at that time, was forced to become an expert on the disease in order to recover. Scott launched the site that later became Celiac.com in 1995 "To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives."  In 1998 he founded The Gluten-Free Mall which he sold in 2014. He is co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.

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