How to Test for Gluten Intolerance and Celiac Disease in Children, Teenagers and Adults

How to Test for Gluten Intolerance and Celiac Disease in Children, Teenagers and Adults

How to test for gluten intolerance: non-invasive, minimally invasive, and invasive. The non-invasive approach involves going on a gluten-free diet for at least 3 months. This strategy is known as the elimination diet or the gluten challenge. After going gluten-free for 3 months you introduce gluten back into your diet and see how you react. If your symptoms come back, it is worth it to stick to the diet. The minimally invasive approach involves blood testing to detect the presence of characteristic autoantibodies, while invasive involves a biopsy of the small intestine (explained below).

What are the symptoms of gluten intolerance?
• Abdominal bloating
• Abdominal pain
• Anemia
• Behavior problems (especially for children and teens)
• Constipation
• Diarrhea
• Malnutrition
• Markedly short stature (especially for children and teens)
• Markedly underweight (especially for children and teens)
• Nausea
• Vomiting

How to test for gluten intolerance: non-invasive

Gluten-free diet
The gold standard for diagnosis is the body’s response to a three-month gluten-free diet. If the anti-tissue transglutaminase (tTG) autoantibody is present and/or the person tests positive for the HLA DQ2 or HLA DQ8 genetic marker, the next step is to begin a strict gluten-free diet. If your symptoms improve by the end of the three-month gluten-free trial, then gluten intolerance and/or celiac disease is an accurate diagnosis. It’s important to remember that other diseases—including autoimmune diseases—may also be present.

Online Self-Assessment
Our online self assessment exam tests your risk for gluten intolerance. This self assessment is not intended to diagnose gluten intolerance. It generates results based on answers given to questions that are common indicators of gluten intolerance. It is best to consult your doctor if you are experiencing symptoms. gluten intolerance test

How to test for gluten intolerance: minimally invasive blood tests

Test One: Anti-tissue transglutaminase
The most accurate blood test measures levels of anti-tissue transglutaminase antibody (tTG). An increase in anti-tTG antibody concentration is found in almost all cases of celiac disease.

Test Two: Anti-gliadin antibodies
A second immunological test measures anti-gliadin antibodies (gliadin is a large protein fragment derived from the partial digestion of gluten). Anti-gliadin antibodies are less predictive of celiac disease as they are found in other diseases as well. But anti-gliadin antibodies do indicate the presence of gluten intolerance.

Test Three: Genetic markers HLA DQ2/HLA DQ8
More than than 97% of people with celiac disease have HLA DQ2 and/or HLA DQ8 antigen-displaying proteins. A positive test—indicating the presence of DQ2 and DQ8 genes—is a very strong predictor that a person has gluten intolerance and celiac disease.

How to test for gluten intolerance: invasive biopsy

Additionally, your doctor may recommend a biopsy of the small intestine. An endoscope obtains small tissue samples to evaluate the presence of characteristic changes associated with chronic inflammation of celiac disease. However, a small intestinal biopsy is not particularly sensitive, as many people with gluten intolerance and celiac disease do not have inflammatory changes. In other words, you may have celiac disease and yet have a normal-appearing small intestine.

If you have gluten intolerance or celiac disease, it is a good idea to get tested for other autoimmune diseases. Gluten intolerance (not necessarily celiac disease) can trigger a chain of immunological and metabolic events eventually causing certain chronic inflammatory and autoimmune diseases. The overall prevalence of autoimmune disease in individuals suffering from gluten intolerance/celiac disease is quite high and our estimation is in the vicinity of 20-30%. It is much easier to treat gluten-driven autoimmune diseases at their early stages compared to the advanced ones when the diet as a solo therapeutic approach is not sufficient enough. Therefore, it is strongly advised to screen all patients with gluten intolerance/celiac disease for coexistent autoimmune/chronic inflammatory diseases. The extent of the screening depends on the results of an individual’s medical history, physical examination as well as experience of the treating physician.

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