diagnosing celiac disease

Villous atrophy is a sign of celiac disease. Villi are small finger-like extensions of the lining of the intestine that are visible only under the microscope.

Celiac disease is a hereditary allergy to gluten that results in damage to the small intestine.

Common symptoms include loose stools, fatigue, weight loss and generally poor health. However, symptoms can vary widely and include constipation, weight gain, and a skin condition called dermatitis herpetiformis.

What Is Gluten? 

Gluten is a protein found in wheat, barley, and rye. Gluten is responsible for the springiness and stretchiness of bread. Without it, bread turns out heavy and dense.

How Is Celiac Disease Diagnosed? 

Celiac disease can be assessed by blood tests or by a biopsy of the small intestine performed during an upper endoscopy. The blood tests include the tissue transglutaminase antibody test and the newer deamidated gliadin antibody test. The endomysial antibody test is older and is not as senstive as the newer tests.

How Common Is Celiac Disease? 

The occurrence of celiac disease is much higher than previously thought. A recent study put the prevalence at 1 in every 133 people, making it one the most common genetic diseases known. Once diagnosed, 1 in 22 first degree relatives, and 1 in 39 second degree relatives, is also diagnosed positive.

How Is Celiac Disease Different from a Gluten Intolerance? 

Although celiac disease is a gluten allergy, it is only one form of gluten allergy. Many react to gluten and may have elevated serum antigliadin antibodies, but they do not have damage to the small intestine. These people have a negative biopsy of the small intestine, as well as negative antiendomysial antibody and tissue transglutaminase tests.

For more information on the proper testing, contact our office with questions at Info@IBSTreatmentCenter.com.


Image thanks to karlloren

Celiac disease is traditionally diagnosed with a positive biopsy of the small intestine. The biopsy will demonstrate damage to the intestine known as villous atrophy. Villi are small finger-like extensions of the lining of the intestine that are visible only under the microscope.

People with celiac disease and other conditions will show a marked reduction in their villi, almost as if the villi have been worn off. Damage to the villi causes a dramatic reduction in the surface area of the small intestine, resulting in both the poor digestion and absorption of many nutrients.

Biopsies are done in a hospital on an outpatient basis, but require strong medication due to the invasive nature of the procedure. An endoscopy is performed, which involves a tube being placed into the mouth, down the esophagus, and past the stomach. A tissue sample can then be taken from the small intestine.

Although the small intestine is extremely important to our health, in most cases the value of the biopsy in diagnosing celiac disease is highly questionable. About 98% of people with a gluten allergy or celiac disease can be diagnosed as being allergic to gluten with a blood tests alone. There is no added benefit from performing the biopsy. The results of the biopsy do not change the form of treatment nor the outcome for the patient. Only if the blood tests are negative can a biopsy potentially provide useful additional information.

Image thanks to karlloren