Celiac & Gluten Testing

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**Includes Consultation, Lab Testing, Interpretation & Treatment Recommendations**

Celiac disease is defined as an autoimmune enteropathy of the small intestine, caused by exposure to dietary gluten in genetically pre-disposed individuals. In susceptible individuals, gluten ingestion generates an inflammatory reaction predominantly centered in the upper parts of the small intestine. This mucosal injury will eventually reduce the intestinal absorptive area and interfere with uptake of micronutrients.

Conditions and symptoms associated with Celiac disease

Chronic diarrhea with weight loss
Steatorrhea
Postprandial abdominal pain
Bloating
Malabsorption with nutrient deficiencies (iron, B12, calcium)
Irritable bowel syndrome
Elevated liver enzymes
Cerebellar ataxia
Peripheral neuropathy
Type I Diabetes

Autoimmune hepatitis
Autoimmune thyroiditis
Infertility
Dermatitis herpetiformis
Sjogren syndrome
Addison's disease
Parathyroid disorders
Growth hormone deficiency
Primary biliary cirrhosis
Primary sclerosing cholangitis

Non-celiac gluten sensitivity (NCGS) is defined as gastrointestinal symptoms and extra-intestinal symptoms that are triggered by gluten consumption, in the absence of Celiac-specific antibodies and villous atrophy, as well as any allergy-related processes. Findings from the clinical history, symptoms, serologic and histologic tests are required in order to reach an accurate diagnosis. A diagnosis of NCGS cannot be made until wheat allergy and CD have been eliminated. Clinicians may consider adding the IgE Food Antibody test that includes the IgE wheat biomarker for wheat allergy. The diagnosis of NCGS is confirmed by a food provocation test. The only known antibodies observed in NCGS patients are anti-gliadin antibodies which occur in only half of the patients.

Conditions and symptoms associated with gluten sensitivity

Irritable bowel syndrome
Abdominal bloating
Abdominal pain
Diarrhea
Nausea
Aphthous stomatitis
Alternating bowel habits

Constipation
"Foggy mind" or inability to concentrate
Fatigue
Headache
Anxiety
Joint pain
Skin rash

Testing should be performed while the patient is still on a gluten-containing diet. The exception is follow-up testing for monitoring treatment efficacy.