Coeliac Screen
What is Coeliac Disease?
Coeliac disease (CD) is a disease that damages the small intestine and interferes with absorption of nutrients from food. People who have CD cannot tolerate gluten, a protein in wheat, rye, and barley. Gluten is found mainly in foods but may also be found in everyday products such as medicines, vitamins, and lip balms.
When people with CD eat foods or use products containing gluten, their immune system responds by damaging or destroying villi—the tiny, fingerlike protrusions lining the small intestine. Villi normally allow nutrients from food to be absorbed through the walls of the small intestine into the bloodstream. Without healthy villi, a person becomes malnourished, no matter how much food one eats.
CD is a life-long disease and affects around 1 in 100 people in the UK. The disease can affect anyone at any age but a definite risk factor is a family history of CD as it is a genetic condition. The only treatment for CD is a gluten-free diet.
What are the symptoms?
CD has many and varied symptoms and can include, although is not exclusive to;
• Weight loss
• Tiredness
• Vomiting
• Lethargy
• Breathlessness
• Abdominal discomfort
• Anaemia
• Mouth ulcers
• Diarrhoea
Because of the broad range of symptoms CD presents it is difficult to diagnose. If undiagnosed, CD patients who continue to ingest gluten will have an increased risk of developing gastrointestinal tumors, so early detection of CD is very important.
Testing for Coeliac.
While an intestinal biopsy is the ‘gold standard’ for diagnosing CD, there are now blood tests available to screen for CD.
Testing is simple and involves either screening a pin-prick of blood for Anti-gliadin (AGA) or tTG-IgA Antibodies.
How Do The Tests Work?
Gliadin IgA and Gliadin IgG test
Gliadin is a major protein found in the gluten fraction of wheat. Antibodies to gliadin are found in approximately 95% of untreated CD patients i.e patients are not on a gluten-free diet. Gliadin IgA antibodies are highly specific for CD and occur in approximately 80% of patients. Gliadin IgG antibodies are also associated with CD but are less specific for the disease as they also occur in a number of other conditions. However, as patients with CD can exhibit IgA deficiency, which gives rise to false negative gliadin IgA results, both classes of antibodies are measured byour tests..
Transglutaminase IgA test
Recent studies have shown that IgA antibodies to tissue transglutaminase (tTG), an enzyme present in the connective tissue of the gut, are also strongly associated with the presence of CD. tTG IgA antibodies are both highly sensitive (95% -100%) and specific (90%-97%) for CD. As with gliadin IgA, if a patient is IgA deficient, the tTG IgA test may be falsely negative; in such cases the gliadin IgG test is recommended.
Results & Treatment
You should consult your GP if your results are above normal. Your GP may follow up the test with an intestinal biopsy to confirm diagnosis.
While there is no cure for CD, sticking to a strict gluten free diet can reverse any damage caused to the small intestine.
Sample requirements and test turnaround Both tests require just a pin-prick blood sample. Results are available within 10 working days.
Important note: The concentration of Gliadin and Transglutaminase antibodies in blood is stimulated by the presence of gluten in the diet. Patients who are on a gluten free diet for more than 2 months may therefore produce normal results in these tests. If you are on a gluten free diet, consult your doctor before changing this regime or ordering any blood tests.
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