Categorized: Celiac Disease Diagnosis

What’s the difference between celiac disease, gluten intolerance, non-celiac gluten sensitivity and wheat allergy?

We use “wheat intolerance syndrome” when referring to the entire category of gluten issues: celiac disease, non-celiac gluten sensitivity and wheat allergy. Celiac disease is an inherited autoimmune disorder that affects the digestive process of the small intestine. “Non-celiac gluten sensitivity” (what many call “gluten intolerance”) causes the body to mount a stress response (often… Read more »

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Is it possible to have a negative blood test, but a positive biopsy?

While rare, it is possible to have a negative blood test and still have celiac disease. tTG sensitivity is approximately 98%, which means that 2% of all celiacs may have a normal tTG level. Sometimes tTG antibodies are not produced enough to show up in the blood stream and can only be detected in the… Read more »

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How do you get a doctor to perform a biopsy when the blood test is negative?

Guidelines may or may not be followed; it all depends on the physician’s judgment in each individual case. Most doctors won’t do a biopsy with a negative test because the test is about 98% accurate. However, by definition, 2% of those with celiac disease do have a negative test, so experienced physicians must handle each… Read more »

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Will the biopsy continue to be the gold standard for diagnosis?

It’s very likely that the biopsy will remain the gold standard for years to come; approximately 90% of new cases are diagnosed using an endoscopic biopsy as part of the diagnosis. Only in rare cases is a diagnosis made without a biopsy as part of the diagnosis. In these rare cases a patient must have at least… Read more »

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What do you recommend for patients with seronegative celiac disease? Do you repeat the scope to ensure that someone is truly gluten free?

For the rare celiac with negative antibodies there is no test other than repeating the biopsy to ascertain full recovery. However, you can assess remission if everything is perfectly fine clinically. In other words, if the symptoms that were present prior to a gluten-free diet have not returned, you may be able to assume the… Read more »

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Can you confirm celiac disease from only a blood test?

Never, in fact. Other variables must be part of a diagnosis. New guidelines in 2011 allow for diagnosis without a biopsy, but only in very rare cases. In these rare cases at least one of the genes must be present, both tTG and EMA blood tests must be more than 10x normal, and there must… Read more »

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