Diagnosis

It may take some time before an accurate diagnosis is made. Some symptoms may be mistaken for irritable bowel syndrome (IBS) or gluten sensitivity, while others may be suppressed. There are numerous symptoms associated with coeliac disease.

Stages of Diagnosis

1. Review the Symptoms – Check if you have any of the symptoms of coeliac disease. Do not remove gluten from your diet at this stage.
2. Take a Blood Test – If your doctor believes further testing is needed, a simple blood test will be conducted to check for antibodies. These may indicate coeliac disease. However, it is possible to have a negative test and still have the disease. Do not remove gluten from your diet at this stage.
3. Undergo a Biopsy – Your doctor will refer you to a gastroenterologist for an intestinal biopsy. Do not remove gluten from your diet until the biopsy is performed.

There are home testing kits for coeliac disease available on the market. However, it is crucial to obtain a medical diagnosis.

Continue eating gluten during the diagnostic process

If you think you may have coeliac disease, it is important to continue eating gluten until a doctor makes a diagnosis.

Diagnostic tests for coeliac disease show how the body reacts to gluten. Some people may start reducing or removing gluten from their diet because they feel unwell. Unfortunately, this is highly likely to result in inaccurate test results, both for the blood test and the intestinal biopsy. That is why it is very important to continue eating gluten throughout the entire diagnostic process.

Важно е да останете на нормална диета, съдържаща глутен, преди да бъдете изследвани за цьолиакия. Имайте предвид, че диетата без глутен, преди да бъдете изследвани за цьолиакия, може да предотврати диагнозата. Ако отстраните глутена от диетата си преди да бъдете подложени на тестове, тялото ви ще започне да се лекува и тестовете ще бъдат ненадеждни. Хората, които вече са на безглутенова диета без да са били тествани за цьолиакия, обаче, може да им се наложи да бъдат  „захранени с глутен“,  за да получат точни резултати от теста.

If you have already reduced or eliminated gluten from your diet, you will need to reintroduce it to ensure the most accurate test results. Although this may be difficult and uncomfortable, it is essential for your long-term health.

What is Gluten Challenge?

Gluten challenge is when you intentionally consume gluten to determine whether your body produces antibodies associated with celiac disease. Specialists treating celiac disease can advise you on how to undertake the gluten challenge. They will recommend the necessary amount and duration of intake. Typically, the recommendation is to consume a small amount of gluten in more than one meal per day for at least six weeks before testing. The usual intake is between 3 to 10 grams per day, with 2 grams being approximately equivalent to one slice of bread. Although ongoing research is exploring ways to significantly shorten the duration of the gluten challenge, it is currently conducted over six to eight weeks, followed by a small intestine biopsy performed via endoscopy. However, recent findings suggest that if you experience severe symptoms and cannot tolerate the full six to eight weeks, a biopsy may be performed after at least two weeks. This would be combined with celiac antibody testing two to four weeks after completing the challenge.

The gluten challenge now requires consuming less gluten over a shorter period of time compared to the past.

While the gluten challenge may sound risky, it is accepted within the medical community. However, you should be closely monitored by a specialist. If you have specific concerns, it is always best to consult your doctor for further guidance.

For children, wheat flour can be added to foods like yogurt or puree to introduce gluten into the diet.

It is important to understand that diagnosing the condition is difficult if you have already started a gluten-free diet. However, obtaining a medical diagnosis is crucial to ensure that you receive the necessary medical follow-up and support recommended for people with celiac disease. Unfortunately, there are no other tests to diagnose the disease besides the antibody blood test and intestinal biopsy. These tests rely on individuals consuming gluten.