Celiac Biopsies a Science of the Past?

If you are exploring the possibility of having Celiac Disease (CD), there are certain steps that your doctor will take with you.  At this point in time, most patients progress from a blood and/or genetic test with positive results to a bowel biopsy.  The bowel biopsy has long been considered the gold standard for a definitive diagnosis of CD.

 However, a new study from Argentina, as reported in Science Daily, suggests that 92% of Celiacs could be diagnosed from blood tests alone.  Check out the link to the study:  http://www.sciencedaily.com/releases/2010/07/100708094603.htm

 Prior to both the blood test for antibodies and the bowel biopsy, the patient must be eating gluten.  Otherwise, the test and biopsy may show as “normal” since the bowel will heal once gluten is removed completely from the diet and the body will no longer be producing antibodies to fight against the gluten.  Staying on a diet with gluten is really easy for those who are asymptomatic but quite a challenge for those who are badly hit by fatigue, diarrhoea and more.  For symptoms of Celiac Disease see:  http://www.celiac.com/articles/1106/1/Celiac-Disease-Symptoms/Page1.html

 The genetic test does not require a specific diet as it only tests for the presence of specific genes but it is not suitable on its own to diagnose either Celiac Disease or gluten intolerance.  It is used more often to screen direct family members of a patient diagnosed with CD to see if they also have the potential genes for the disease.

 The study from Argentina does not indicate whether the blood serology tests they recommend require the patient to be eating gluten at the time of the test.  If they require gluten in the diet at the time of testing, it still doesn’t solve the problem that many of those face who are looking for a diagnosis.  Namely, if you are already on a gluten free diet and feeling fantastic, why would you want to go back to eating gluten for a diagnosis you already believe in anyway?

 And finally, even if this Argentinean study is correct, there are still reasons to have a biopsy anyway.  Since there are many other health issues that may affect a Celiac from cancer to infection, a baseline view of your bowel could diagnose other health issues that must be addressed.  But this certainly may open up a good discussion for you and your health professional.