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How is Coeliac Disease Diagnosed?

Diagnosing Coeliac disease involves serology and genetic tests, followed by endoscopy or capsule endoscopy for confirmation. Nutritional assessments and regular check-ups are crucial for managing the condition, along with medication options.

  • 12 Feb 2024
  • 2 min read
  • 9 views

Diagnosing Coeliac disease involves a crucial sequence of tests, predominantly serologic tests and genetic screenings. These screenings detect antibodies and genetic markers, laying the foundation for further diagnostic procedures. It's pivotal to identify this condition before adopting a gluten-free diet, as it impacts test outcomes. Additional tests like endoscopy or skin biopsies may follow for confirmation. There are several tests to diagnose this disease, let’s take a look at them one by one.

Diagnosis of Coeliac Disease

Numerous Coeliac disease sufferers are unaware of their condition. Two blood tests can assist in the diagnosis:

  • Serology testing: A serology test scans your blood for antibodies. Increased concentrations of certain antibody proteins signify an immunological response to gluten.
  • Genetic testing: Coeliac disease can be ruled out by genetic testing for human leukocyte antigens (HLA-DQ2 and HLA-DQ8).

It's crucial to get a Coeliac disease test before incorporating a gluten-free diet. Removing gluten from your diet may help blood test results fall within the normal range.

One of the following tests will probably be requested if the findings of these tests point to Coeliac disease:

  • Endoscopy: This examination involves inserting a lengthy tube down your throat that contains a small camera. Using a camera, the doctor can see within your small intestine and remove a biopsy sample of tissue to check for villi damage.
  • Capsule endoscopy: This test takes images of your whole small intestine using a tiny wireless camera. You ingest a capsule the size of a vitamin that contains the camera. The camera in the capsule collects hundreds of images as it passes through your digestive system and sends them to a recorder. When a complete or terminal examination of the small intestine is required, this test is utilized.

A little sample of skin tissue may be taken by your medical practitioner to be examined under a microscope to determine whether you have dermatitis herpetiformis.

It can be advised to undergo extra tests to assess your nutritional condition if you are diagnosed with Coeliac disease. This comprises the following: mineral levels, haemoglobin, liver enzymes, and the levels of vitamins A, B-12, D, and E. A bone density scan may also be used to assess the health of your bones.

Follow-up Care

  • Regular check-ups with the doctor to assess the progress of symptoms; regular monitoring of blood tests and nutritional indicators.
  • A gluten-free diet helps the small intestine repair, which takes many years for adults and three to six months for youngsters.
  • If symptoms worsen or persist, endoscopy with biopsies can be required.

Medication to Control Intestinal Inflammation

Steroids may be advised to reduce inflammation if you have refractory Coeliac disease or significant damage to your small intestine. While the gut heals, steroids can lessen the severe symptoms of Coeliac disease.

Other medications like budesonide (Entocort EC, Uceris) or azathioprine (Azasan, Imuran) may be utilised.

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Conclusion

Accurate diagnosis of coeliac disease often begins with serologic tests, particularly those examining IgA antibodies. Genetic screenings for HLA markers are also instrumental. Timely identification is crucial before altering dietary habits. While someone having this disease can leave you worried, we want you to know that there are several diagnoses and treatments for the same. However, these tests are often expensive to begin with. In that case, you must get a comprehensive health insurance plan beforehand to avoid that financial burden on your pocket. 

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