Proper diagnosis in every condition, especially in celiac disease, can lead to a more efficient approach and thus a faster treatment. This is why, it is highly important that once you individuate some of the celiac disease symptom you DO NOT cut on gluten products, but rather go to the doctor for a thorough examination. In some cases, Chron’s disease, irritated bowel syndrome or pancreatic insufficiency may be mistakenly taken for celiac disease or vice versa, which may lead to an improper treatment. Only the doctor can prescribe a gluten-free diet, after a complete examination.
The first step to take when you experience symptoms associated with celiac disease is to tell your doctor about it. Based on your account and on an external examination (looking for emaciation, pallor, skin rashes, dermatitis, signs of vitamin, minerals, calcium or magnesium deficiencies, etc.) the doctor will decide the next steps to be followed.
In case of celiac disease suspicion, the primary blood test which needs to be done is TTG which measured the levels of an enzyme called tissue transglutaminase. These enzymes are freed inside the body when the intestine is affected by the celiac disease. The test can be done on immunoglobulin A or G. TTG IgA are most common and since 2006 are considered the standard for celiac disease diagnostic by the American Gastroenterological Association. Its results are correct in proportion of 90 to 95%. Yet, there are also chances that the results may be false negative, mainly in persons which normally have a lower IgA. This is why, some doctors ask for a TTG IgG when available.
Other blood tests usually done for a proper diagnosis are antigliadin (AG) and deamidated gliadin peptide (DGP). These tests are thought to be less successful in individuating celiac disease, but they work perfectly in diagnosing other intestinal diseases which have similar symptoms. So, they are also used for excluding other causes for the symptoms displayed by celiac suspects.
Blood tests are only the starting point in celiac disease diagnosis. If they are positive (the IgA are higher than normal), then the next step should be done: biopsy. An esophagogastroduodenoscopy or EDG will be performed in order to extract some tissue from the small intestine. The portions of tissue excised will be analyzed and the final result will shed light about the type of condition the patient suffers from. The EDG is thought to be the ultimate and the best way to diagnose celiac disease.
According to the results displayed by blood tests and EDG, the patient will be prescribed the proper treatment, accompanied or not by a gluten-free diet.