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How diagnosed celiac disease is diagnosed - nutrition celiac
Celiac disease is a chronic autoimmune condition that manifests itself in genetically predisposed individuals when they consume gluten. Treatment consists of a lifelong gluten-free diet. However, before starting treatment, an accurate diagnosis is essential.
The diagnostic process can be complicated and extensive, as symptoms vary from person to person and some patients may have no symptoms. Because of this, it can often go undetected in primary health care. Many people may have celiac disease without knowing it. If celiac disease is suspected, it is best to see a specialist, such as a gastroenterologist.
The diagnosis should be based on the evaluation of medical history, symptoms, blood screening tests, genetic tests and intestinal biopsy. In addition, it is important to follow the evolution of the patient after the adoption of a gluten-free diet to verify clinical and histological improvement.
The following are the steps involved in the diagnosis of celiac disease.
The physician will review the patient's medical history to determine if he or she belongs to a risk group, such as people with type 1 diabetes, lactose intolerance, autoimmune thyroiditis, Down syndrome, or if he or she has close relatives with celiac disease.
A physical examination will also be performed to look for digestive or non-digestive symptoms, such as chronic diarrhea, weight loss, fatigue, anemia, constipation, skin rashes, joint pain, osteoporosis, infertility or emotional problems such as depression and anxiety.
The specialist will also ask about lifestyle and possible recent changes, as well as any medications the patient is taking.
If the doctor suspects celiac disease, he or she may order blood tests to detect antibodies. Early detection is vital, as untreated celiac disease can cause serious complications such as osteoporosis, infertility and bowel cancer.
More specific serological tests include:
These tests may indicate the presence of the disease, but they are not definitive. Some celiacs do not have elevated antibodies, so other tests may be necessary. In addition, it is crucial not to stop eating gluten before these tests are performed, as it may affect the results.
Genetic testing confirms whether a person is predisposed to developing celiac disease. The HLA DQ2 and HLA DQ8 genes are associated with celiac disease, but their presence does not guarantee the development of the disease.
If these genes are present and antibody tests are negative, an intestinal biopsy may be recommended to confirm the diagnosis. If the genetic result is negative, celiac disease can be almost completely ruled out.
Intestinal biopsy, performed by endoscopy, involves taking samples from the small intestine for examination under a microscope. This procedure is considered the most reliable method of confirming celiac disease, as it reveals damage to the intestinal mucosa.
While it is a safe procedure, there may be small risks of complications, such as bleeding or infection. It is important to discuss any concerns with your doctor.
Regardless of the test results, an additional step in the diagnosis may be to follow a gluten-free diet and observe the patient's response. After 6 months, there should be significant improvement in quality of life, although recovery from intestinal damage may take longer.
