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Just because you experience symptoms after eating foods that contain gluten, this does not mean you have coeliac disease. The definitive test is a biopsy from the surface of the small intestine.

A flexible telescope (endoscope) is usually passed through the mouth into the stomach and upper intestine so that the lining can be inspected and a biopsy taken. This process takes only a few minutes and is often made easier and less uncomfortable by giving the patient a mild sedative beforehand. Alternatively, a biopsy can be obtained by swallowing a special capsule on the end of a narrow tube.

If the biopsy is abnormal, a second test may be advised after a period to check that the intestinal surface has returned to normal.

When there is doubt about an earlier diagnosis, or the changes seen on biopsy are uncertain, another biopsy may be advised after a person has deliberately eaten gluten for a period (this is called a ‘gluten challenge’).

Blood tests are helpful in detecting the body’s reaction (antibodies) to gluten or as an indication of intestinal damage. The blood test that can give a strong indication of coeliac disease analyses tissue transglutaminase IgA levels along with reticulin and endomysial IgA antibodies. A positive result in this test also gives an indication of an inherited susceptibility to gluten intolerance. Other blood tests can be used to identify deficiencies of iron, vitamins such as folic acid, or minerals such as calcium. Such blood tests are useful for screening relatives or to ascertain whether a gluten sensitivity may be the cause of symptoms or of nutrient deficiency. These tests do not make the diagnosis, but indicate the advisability of a biopsy test.

If abdominal symptoms are troublesome or develop despite treatment, a barium X-ray of the intestine, which involves swallowing a tasteless white liquid, may be advised.

For more information about coeliac disease, please contact:

Coeliac Society of the UK

PO Box 220

High Wycombe, Buckinghamshire

HP11 2HY

Tel: 01494 437 278

www.digestivedisorders.org.uk