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  • Scott Adams

    One Blood Test Can Now Diagnose Celiac Disease without Biopsy

    Scott Adams
    6 6
    Reviewed and edited by a celiac disease expert.

      An upcoming report by British researchers for the leading gastroenterology journal Gut, shows that the blood test alone is 95 per cent accurate for diagnosing celiac disease.

    Image: CC BY 2.0-- UC Davis College of Engineering
    Caption: Image: CC BY 2.0-- UC Davis College of Engineering

    Celiac.com 09/24/2020 - Celiac disease is an autoimmune condition in which eating wheat, rye, or barley triggers an adverse immune reaction in the gut. Celiac disease affects about one percent of the population. Diagnosis can be a long and arduous process. In the United States, the average person with celiac disease can wait up to ten years from the time of first symptoms to diagnosis. Left undiagnosed, autoimmune disease can cause organ damage and bowel cancer.

    Anyone who has ever had to suffer through a long, convoluted process to get their celiac disease diagnosis can now rejoice for any new celiacs going forward. That's because researchers have developed a single blood test that can diagnose celiac disease without biopsy. Until now, the "gold standard" for celiac diagnosis was the duodenal biopsy, which is normally performed by a gastroenterologist in the days or weeks after a positive blood test, during which time the patient needs to keep consuming gluten. However, nearly half of patients did not need to undergo a more risky biopsy procedure at all.

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    This data, coupled with the need to catch up with a backlog of endoscopies created during the Covid-19 pandemic, has provoked a change in guidance from the British Society of Gastroenterology and The National Institute for Health and Care Excellence (NICE). An upcoming report by British researchers for the leading gastroenterology journal Gut, shows that the standard tTG blood test alone is 95 percent accurate for diagnosing celiac disease.

    Trials show the tTG blood test to be 95 percent sensitive (meaning it detects celiac disease 95 times out of 100), and 95 percent specific (meaning it gives a false positive result just 5 times out of 100). The test measures blood levels of anti-transglutaminase antibodies, or tTG2, which are higher in people with celiac disease. 

    TTG2 proteins are among the proteins trigger the immune reaction the causes inflammation when celiac eat wheat, rye, or barley. Celiacs have hundreds times more tTG proteins than non-celiacs.

    Being able to diagnose celiac disease quickly and accurately, via blood test alone, is a huge game-changer for celiac patients. Tens of thousands of people with suspected celiac disease can now get a diagnosis with a simple blood test, sparing them from the more risky biopsy procedure.

    Not only will many be spared the prolonged side-effects, and invasive, drawn-out diagnosis, they will also be spared the long-term damage that come with undiagnosed celiac disease.

    Read more at DailyMailnews-medical.net, and bmj.com.

    Edited by Scott Adams

    6 6

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    Just a few days ago, I happened to talk to Dr. Guandalini, the founder of the University of Chicago Celiac Center (please feel free to do a web-search, who he is) about the recent good test results of my own children and how it relates to GliadinX. He actually performed the endoscopy on one of my children. His opinion is that endoscopy is widely overused for diagnosis of celiac disease in the US and that many, if not most endoscopies are not necessary. 

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    3 hours ago, Guest Kansas said:

    Okay, but how do I get this blood test?? Is it available in the US yet?

    There is no special celiac antibodies test — just the usual ones offered.  The article just states that if your celiac antibody results are very high, you can probably skip the endoscopy.  Ask your doctor to get tested.  

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    No. If you are following a strict gluten free diet, the test will not be accurate. That is the reason why they say the person needs to be consuming gluten. 

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    1 hour ago, sc'Que? said:

    Will it still work if you are already following a strict gluten-free diet?  

    I am wondering the same thing. This would be excellent if those already on a strict gluten free diet could have an accurate diagnosis without having to eat gluten for a period of time. 

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    4 hours ago, Guest Happy camper said:

    I have silent celiac, which makes it harder to not eat gluten. Wondering how bad is it to still eat some gluten, should I be worried?

    Yes, you should - By eating gluten you are still doing damage to your small intestines which, if it is not controlled, can lead to severe diseases such as cancer.  Also, you may not have gastrointestinal symptoms but Celiac Disease has been tied to dozens of non-gastrointestinal maladies from joint aches to depression.  Please take care of yourself and avoid gluten

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    On 9/24/2020 at 4:11 PM, cyclinglady said:

    Ah, but....

    ”Those with antibody levels lower than ten times the normal range will still require an endoscopy before the diagnosis can be confirmed.”

    An endoscopy is still valuable per the referenced article.  

    This is a small percent of people. What this article means is that the vast majority of people will not need a biopsy, and it is no longer the "gold standard" of diagnosis. The gold standard is now blood screening, and only in a small number of cases should a biopsy be considered. Gastroenterologists will be bummed. 😄

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  • About Me

    Scott Adams 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. In 1995 he launched the site that later became Celiac.com to help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives.  He is co-author of the book Cereal Killers, and founder and publisher of the (formerly paper) newsletter Journal of Gluten Sensitivity. In 1998 he founded The Gluten-Free Mall which he sold in 2014. Celiac.com does not sell any products, and is 100% advertiser supported.

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