How Antibody Tests Assist in Diagnosing Celiac Disease
Many children and adults suffer from celiac disease, a genetic immune disorder characterized by the body’s abnormal response to gluten. The gravity of this disease becomes apparent when one considers the great number of foods and manufactured products that contain gluten. While wheat, rye and barley are the most obvious and well known, many people fail to realize that the substance also occurs in many vitamins and medicines.
In response to the presence of gluten, celiac disease produces an inflammatory response that ravages the villi lining the small intestine. The villi play an essential role in the digestive process, and their damage impairs the body’s ability to absorb nutrients.
Celiac disease also encourages the production of antibodies, a fact that led to the development of blood tests to detect their presence. Physicians now credit antibody testing with enabling them to detect a substantially larger number of celiac cases in children.
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Prior to the advent of antibody testing, when custom antibody production wasn’t available to scientists as it is today, physicians suspected celiac disease mainly when babies and young children presented with the typical manifestations of intractable diarrhea and weight loss. Testing has since shown that celiac disease can announce its presence through a much wider range of symptoms. These include acid reflux vomiting, abdominal pain and constipation, all of which are indicators of atypical celiac disease.
The detection of these antibodies is not, by itself, diagnostic. Only an internal biopsy of the small intestine can make that determination. The discovery of damage to the villi in this area will confirm the diagnosis.
A study referenced in the journal Pediatrics found that following the 1997 introduction of antibody testing, physicians diagnosed celiac disease at a rate three times greater than had previously been the case. Moreover, most of the children so diagnosed had never presented with the classic symptoms.
The study concerned 266 children referred for internal biopsy to Alberta Children’s Hospital in Canada. It compared the number of diagnoses made between 1990 and 1996, before antibody testing, with those made later.
In the earlier group, only 36 children, most of whom were about 2 years of age, received a diagnosis of celiac disease. Over two-thirds of them had shown classic symptoms of the disorder.
Between 2000 and 2006, however, 199 children, some as old as 9 years, were diagnosed with the disease. Only 19 percent of them had presented with classic symptoms. Thirty-eight percent had complained of such atypical indicators as abdominal pain and constipation, and 15 percent showed only poor growth and iron deficiency.
Perhaps most telling, however, was the fact that 28 percent of the diagnosed children had received the original antibody testing only because of familial risk factors. They had complained of no symptoms whatsoever.
Many physicians now recommend antibody testing for all children who suffer from chronic digestive problems. Although there is no cure for celiac disease, adherence to a gluten-free diet will enable sufferers who are aware of the problem to manage the disease.
