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What should I do if I think I have coeliac disease?

What should I do if I think I have coeliac disease

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What should I do if I think I have coeliac disease?

If you think you or your child has coeliac disease, you must keep eating gluten and speak to your/their GP for advice and reach a diagnosis.

How is coeliac disease diagnosed?


Recognizing coeliac disease can be difficult because some of its symptoms are similar to those of other diseases. Coeliac disease can be confused with irritable bowel syndrome, iron-deficiency anemia caused by menstrual blood loss, inflammatory bowel disease, diverticulitis, intestinal infections, and chronic fatigue syndrome. As a result, coeliac disease has long been underdiagnosed or misdiagnosed. As doctors become more aware of the many varied symptoms of the disease and reliable blood tests become more available, diagnosis rates are increasing.

Blood Tests

People with coeliac disease have higher than normal levels of certain autoantibodiesproteins that react against the body's own cells or tissuesin their blood. To diagnose coeliac disease, doctors will test blood for high levels of anti-tissue transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA). If test results are negative but coeliac disease is still suspected, additional blood tests may be needed.

Before being tested, one should continue to eat a diet that includes foods with gluten, such as breads and pastas. If a person stops eating foods with gluten before being tested, the results may be negative for coeliac disease even if the disease is present.

Intestinal Biopsy

If blood tests and symptoms suggest coeliac disease, a biopsy of the small intestine is performed to confirm the diagnosis. During the biopsy, the doctor removes tiny pieces of tissue from the small intestine to check for damage to the villi. To obtain the tissue sample, the doctor eases a long, thin tube called an endoscope through the patient's mouth and stomach into the small intestine. Its painless, and doctors then takes the samples using instruments passed through the endoscope.

Dermatitis Herpetiformis

Dermatitis herpetiformis (DH) is an intensely itchy, blistering skin rash that affects 15 to 25 percent of people with coeliac disease. The rash usually occurs on the elbows, knees, and buttocks. Most people with DH have no digestive symptoms of coeliac disease.


DH is diagnosed through blood tests and a skin biopsy. If the antibody tests are positive and the skin biopsy has the typical findings of DH, patients do not need to have an intestinal biopsy. Both the skin disease and the intestinal disease respond to a gluten-free diet and recur if gluten is added back into the diet. The rash symptoms can be controlled with antibiotics such as dapsone. Because dapsone does not treat the intestinal condition, people with DH must maintain a gluten-free diet.

Screening

Screening for coeliac disease means testing for the presence of autoantibodies in the blood in people without symptoms. Americans are not routinely screened for coeliac disease. However, because coeliac disease is hereditary, family members of a person with the disease may wish to be tested. Between 4 and 12% of an affected person's first-degree relatives will also have the disease.

How is coeliac disease treated?
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