celiac disease 2

Diagnosis of CD
Treatment of CD
What are the complications of celiac disease?
Diseases Linked to Celiac Disease

Diagnosis of CD

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CD is often missed because its symptoms can suggest so many other diseases. If the doctor is aware of the disease, the diagnosis is made more frequently and missed less often. GPs in Britain and other European countries are familiar with the disease which may account for the apparent increased prevalence in Europe.

The doctor can do blood tests for immune globulins in suspected cases.
IgA - immunoglobulin A
tTGA - anti-tissue transglutaminase
AEA - anti endomysium antibodies

A small bowel biopsy looking for the typical damaged villi follows a positive blood test for confirmation.
In spite of this, some cases will be missed. If the doctor or parent strongly suspects CD it is easy enough to go on a gluten free diet for a week or two. Very severe cases have damage to the small bowel that cannot repair itself, and these will not respond much to a gluten free diet. However most others will see an immediate and spectacular improvement. These patients improve so much that they will not be able to be convinced to go back on gluten as a test.

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Treatment of CD
The only successful treeatment is the strict adherence to a gluten free diet. Avoid wheat, barley and rye, triticale and oats if the oats are milled in North America. If you can buy British or Irish oats, you may include them in your diet.
The response is usually so gratifying that there is no difficulty in maintaining adherence. Some patients who have associated diseases get great relief from these diseases which bolsters adherence. A patient who suffered from severe arthritis of the hands, and who was able to stop her anti-inflammatories after 4 days on the diet decided not to have the bowel biopsy: she was going to stay on the diet no matter what!

Once off gluten the patient often becomes apparently more sensitive: even a trace of gluten e.g., as a contaminant in a restaurant, will cause a worse attack than prior to diagnosis. Usually this responds rapidly to resumption of the diet.

CD sufferers become label-readers. Gluten and wheat derivatives are so commonly used in processed foods that the patient has to become an expert in biochemistry, and in the recognition of ingredients that may seem unrelated but are in fact dangerous such as "modified food starch" or some forms of maltodextrin.