All About Celiac Disease and Celiac Testing
Celiac disease, from the Latin word for “abdominal cavity,” occurs when the body rejects a protein called gluten, which is found in grains such as wheat, barley and rye. Gluten is present in much of the food we eat, often as an unexpected ingredient. It’s also in many products we use every day, from vitamins to medications and lip balms.
The disease is one of a group of conditions – including multiple sclerosis and type 1 diabetes – that are classified as “autoimmune” because the body’s immune system, which is supposed to guard it against outside pathogens such as infectious disease, turns on itself for some reason.
In the case of celiac disease, the immune system rings an alarm whenever gluten is detected, causing the lining of the small intestine to become inflamed and damaged. This blocks the digestive system from absorbing essential nutrients such as iron, folate and fat-soluble vitamins A, D, E and K. Untreated, celiac disease can lead to malnutrition, sometimes severe, related health conditions, and certain cancers.
Who Has Celiac Disease?
Not so long ago in North America, celiac disease was frequently overlooked and its symptoms dismissed as little more than digestive issues. Family doctors often did not stray beyond obvious diagnostic profiles of bloating and diarrhea.
New research shows that many patients still make the rounds, from one doctor to another, for an average of 12 years before finding out what is wrong. But physician awareness is improving rapidly. In past, many patients were even told their problems were psychosomatic and resigned themselves to a lifetime of discomfort and worse.
Today, there are signs of change, bolstered by recent research shows that at least 1 per cent of the population in North America has celiac disease, a statistic that has increased fourfold from 50 years and only promises to get larger.
Experts aren’t sure why: Dr. Peter Green, the founder of the Celiac Disease Center at Columbia University, speculates that it could be because gluten is present in more products than ever before, or it simply could have become more toxic to an increasing number of individuals over time.
Its fast rise may also be due to the fact that medical practitioners are now more knowledgeable about the conditions and willing to consider celiac disease as a diagnosis when faced with celiac’s array of symptoms. They also have more precise diagnostic tools at their disposal.
Celiac disease runs in families and once you have it, it’s for life. That doesn’t mean you are born with it. But you may have a predisposition that is suddenly triggered by an event, an accident, stress or another illness, for example. That could have occurred when you were 3 years old, or 13 or 30. All of a sudden, your immune system reacts strongly to gluten – and you must vigilant forever after about what you put into your body.
If you have a close relative who has been diagnosed with celiac disease or suspect that you may have it, with symptoms that are persistent and uncomfortable no matter what measures you take to alleviate them, get screened immediately.
Testing is done in two stages, the first being a simple blood test that rules out classic allergies by identifying antibodies linked to the celiac disease. The blood screening is called tissue transglutaminase (tTG) and endomysial antibody (EMA) – both a mouthful to say but still not 100 per cent accurate.
The only way to know for certain if you have celiac disease is to undergo a biopsy of your small intestine, which should be done by a gastroenterologist in a hospital outpatient setting.
There is another initial testing option available in Canada and some European countries. Called the CeliacSure (formerly BioCard) Test, it measures the presence in your blood of antibodies that indicate you are having an immune response to gluten. The Canadian Celiac Association says data on the accuracy of the home test (not yet FDA-approved in the U.S.) is limited, but has called the test may be a useful first step in determining whether a full screening is needed.
But an indicator is all it is. Remember to continue eating gluten until a physician has diagnosed celiac disease through an intestinal biopsy. If you stop, the findings could be affected.
The Only Treatment
Right now, there is no medical cure for celiac disease, not a vaccination, not a magic pill to temporarily allow you to eat gluten without consequence.
With research currently being conducted the world over, from Australia to the U.S. and Europe, those are coming. But for now, the only sure-fire way to deal with your errant immune system is to eliminate gluten from your diet, period. This means being hyper vigilant.
The good news is that as consumer awareness is be growing, governments and food manufacturers have taken notice of the growing needs of the celiac community. Food labels have vastly improved and there has been a dramatic surge in gluten-free food products on the market. Many savvy restaurants now offer gluten-free menus or at least dishes and a careful kitchen.
In managing life gluten-free, learn to read product labels and have a list of “safe” restaurants in your city. Don’t be afraid to ask questions when shopping, traveling or at a restaurant. Most important of all, make this your motto: When in doubt, leave it out.