Unfortunately there is no definitive test for celiac disease. However, there are many ways to determine if it is likely or not that you do in fact have the disease. Because not much is known about the disease, what causes it and what defines it, even the available tests can prove to be false negatives and lead to misdiagnosis. The only sure test is a gluten-elimination diet. If you feel better when not eating gluten, it is thereby the culprit. However, gluten intolerance doesn’t necessarily mean you have celiac disease. Among the available tests is: a small bowel biopsy during an endoscopy, stool sample analysis, colonoscopy (to rule out other diseases) and blood tests to determine levels of immunoglobulin A, anti-endomysium antibodies and anti-tissue transglutaminase.
Diagnosing Celiac Disease
When it comes to diagnosing Celiac disease, there is a lot of confusion both within and outside of the medical community. Patients with chronic symptoms are looking for answers and doctors are wrestling with a less than clear understanding of the disease, as well as a battery of tests that may all be inaccurate some of the time.
Lack of Knowledge
One major obstacle to increase the instances of doctors diagnosing Celiac disease accurately and efficiently is simply that it’s not the first thing that comes to mind. Awareness of this disease, and indeed an understanding of how frequently it actually occurs are relatively recent developments in this country. Particularly for doctors who have been in practice for a longer period of time, Celiac disease just isn’t something that pops up on their radar frequently.
This also means that there is a huge variation in the type of care that many people with the same symptoms receive. Doctors experienced in diagnosing Celiac disease will recognize the combination of symptoms and recommend specific tests much sooner than their less-experienced counterparts. Of course, unless you’re already seeing a specialist, you will have very little way of knowing how much experience your doctor has with this disease.
Reliance on Blood and Other Tests
Even once tests are ordered, however, diagnosing Celiac disease can be a complicated process. There are several blood tests that measure the levels of particular antibodies, as well as genetic tests to determine if Celiac disease is even an option. If the antibody tests come back positive or if there is reason to think that a false-negative result has been attained, your doctor may recommend an intestinal biopsy via an endoscopy or colonoscopy.
While these tests are all useful, they can also all come back with false negatives for a variety of reasons, including a patient who has already taken it upon themselves to stop eating gluten. Many diagnoses of Celiac disease are missed for just this reason, and the patient can be left with only more questions and no answers. Although these tests are important and often correct, many doctors tend to put too much emphasis on their results.
Go with How You Feel
While there are certainly several good reasons to pursue a definitive diagnosis of Celiac disease, you will have to weigh the benefits for yourself. Some people feel that diagnosing Celiac disease is important because it provides information to your family members about whether they should also be tested even if they have no symptoms. There are also those, both within and outside of the medical community, who think that the difficulties with maintaining proper nutrition on a gluten free diet mean that no one should just switch to this type of eating pattern unless they have a diagnosis that determines it to be medically necessary.
These are certainly both valid concerns, and you will have to decide for yourself what tests you want to be subjected to, particularly if that means reintroducing gluten to your diet in order to get an accurate result. Also, keep in mind that, even if all of the tests you take for diagnosing Celiac disease come up negative, you may still benefit from eating gluten free. As long as you listen to your body and make sure you’re getting proper nutrition, there really doesn’t need to be a down-side to eating gluten free.
CELIAC DISEASE SYMPTOMS
- Abdominal/ stomach cramping/bloating and pain
- Appetite increased to the point of craving
- Behavioral changes
- Chronic Diarrhea
- Dermatitis herpetiformis, an itchy skin rash
- Dry skin
- Energy loss
- Mouth sores
- Muscle cramping
- Stools are loose, pale, rancid, frothy, discolored
- Stunted height
- Weight loss or gain