Tests for Celiac Disease:
- Albumin (may be low)
- Alkaline phosphatase (high level may be a sign of bone loss)
- Clotting factor abnormalities
- Cholesterol (may be low)
- Complete blood count (CBC – test for anemia)
- Liver enzymes (transaminases)
- Prothrombin time
- A chemistry screen, to check for mineral and electrolyte imbalances.
- Thyroid hormone tests, to check for thyroid problems.
- A bone density test. This may be done to see if you have problems such as osteomalacia (known as rickets in children) or osteoporosis, which may develop in some people with celiac disease.
Blood tests can detect several special antibodies, called antitissue transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA). The health care provider will order these antibody tests if celiac disease is suspected.
If the tests are positive, upper endoscopy is usually performed to sample a piece of tissue (biopsy) from the first part of the small intestine (duodenum). The biopsy may show a flattening of the villi in the parts of the intestine below the duodenum.
Genetic testing of the blood is also available to help determine who may be at risk for celiac disease.
A follow-up biopsy or blood test may be ordered several months after the diagnosis and treatment. These tests evaluate your response to treatment. Normal results mean that you have responded to treatment, which confirms the diagnosis. However, this does not mean that the disease has been cured.
Treatment of celiac disease:
Celiac disease cannot be cured. However, your symptoms will go away and the villi in the lining of the intestines will heal if you follow a lifelong gluten-free diet. Do not eat foods, beverages, and medications that contain wheat, barley, rye, and possibly oats.
You must read food and medication labels carefully to look for hidden sources of these grains and ingredients related to them. Because wheat and barley grains are common in the American diet, sticking with this diet is challenging. With education and planning, you will heal.
Never begin the gluten-free diet before you are diagnosed. Starting the diet will affect testing for the disease.
Vitamin and mineral supplements that has iron and calcium are prescribed to correct nutritional deficiencies. Sometimes, corticosteroids (such as prednisone) may also be prescribed for short-term use or if you have sprue that does not respond to treatment. Following a well-balanced, gluten-free diet is generally the only treatment you need to stay well.
When you are diagnosed, get help from a registered dietitian who specializes in celiac disease and the gluten-free diet. A support group may also help you cope with the disease and diet.
Following a gluten-free diet heals the damage to the intestines and prevents further damage. This healing most often occurs within 3 – 6 months in children, but it may take 2 – 3 years in adults.
Rarely, long-term damage will be done to the lining of the intestines before the diagnosis is made.
Some problems caused by celiac disease may not improve, such as a shorter than expected height and damage to the teeth.
Complications of celiac disease:
You must carefully continue to follow the gluten-free diet. When untreated, the disease can cause life-threatening complications.
Delaying diagnosis or not following the diet puts you at risk for related conditions such as:
- Autoimmune disorders
- Bone disease (osteoporosis, kyphoscoliosis, fractures)
- Certain types of intestinal cancer
- Low blood count (anemia)
- Low blood sugar (hypoglycemia)
- Infertility or repeated miscarriage
- Liver disease
Prevention of celiac disease:
Because the exact cause is unknown, there is no known way to prevent the development of celiac disease. However, being aware of the risk factors (such as having a family member with the disorder) may increase your chances of early diagnosis, treatment, and a long, healthy life.
Celiac disease is an immune system disorder in genetically predisposed people that results in damage to the lining of the small intestine when foods with gluten are eaten. The risk for the disease may be inherited, since about 10% of first-degree relatives (mother, father, brother, sister, son, or daughter) of people who have celiac disease also develop the condition. Certain viral and bacterial infection can initiate disease in genetically predisposed individuals. Although celiac disease cannot be prevented, symptoms and damage to the small intestine can be reversed by maintaining a strict gluten-free diet. At first, you may also have to avoid milk and milk products. After you stop eating gluten, the intestines begin to heal and you likely will be able to gradually reintroduce milk products into your diet without triggering symptoms.
Some adults with celiac disease have a poorly functioning or nonfunctional spleen, which is a risk factor for developing a pneumococcal infection. For this reason, your doctor may recommend that you get immunized with the pneumococcal vaccine.
What is silent celiac disease?
It refers to patients who have abnormal antibody blood tests for celiac disease as well as loss of villi in the small intestine but have no symptoms or signs of celiac disease, even on a normal diet that contains gluten. Like patients with latent celiac disease, these patients can develop signs or symptoms of celiac disease later in life.