I think I have Celiac Disease.
Should I be Diagnosed?
Another school of thought is that without a formal, medical diagnosis, it may be harder to maintain a strictly gluten free diet, because there is always that nagging doubt "maybe it's not true". Many biopsy-confirmed celiacs have that because once you are health and feeling great, it's hard to believe one is really sick.
How to be Diagnosed?Genetic Testing - Saliva tests to determine if one has a genetic link to develop Celiac Disease. In order to have Celiac Disease, one must have genetic pre-disposition to develop Celiac Disease. This means that Celiac is an inherited condition. Without the genetic link, one will never develop Celiac Disease. Several companies now provide Celiac Genetic Testing directly to consumers:
Blood Testing - People with celiac disease have higher than normal levels of certain autoantibodies—proteins that react against the body’s own cells or tissues—in their blood. To diagnose celiac 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 celiac disease is still suspected, additional blood tests may be needed. Disadvantage to Blood Testing: one has to be eating gluten. If one is not eating a diet that includes foods with gluten, such as breads and pastas, the results may be negative, even though celiac disease is present.
Upper Endoscopy - If blood tests and symptoms suggest celiac disease, a biopsy of the small intestine is performed to confirm the diagnosis. This is usually done under light sedation and involves no pain. A long, thin tube called an endoscope is placed through the patient’s mouth and stomach into the small intestine. The sedation relaxes the "gag" reflex and allows the doctor to obtain samples. During the biopsy, the doctor removes tiny pieces of tissue from the small intestine to check for damage to the villi, the small hair-like strucures in the duenduonem, the opening to the small intestine. If Celiac Disease is present, the villi are damaged and will be apparent by bipsy.
Gluten Challenge - A gluten challenge involves eliminating all gluten from one's diet to see if symptoms improve. The idea is similar to an elimination diet when one is seeking to determine food allergies.