A research team in Norway recently broke the news that they are in the clinical trial phase of such a test — a blood test that can accurately diagnose celiac disease. They are currently testing people who have already been diagnosed with celiac disease, those who do not have it, and those who have symptoms but don't yet have a diagnosis. The Norwegian team hopes to have it on the market in a few years.
Why is this such a big deal? Well, diagnosing celiac disease is a lengthy and invasive multi-step process.
First, we must understand that celiac disease is an autoimmune disease where your body treats the gluten you consume as an invader, and in response, your immune system attacks, damages or destroys the villi in your intestines. This makes it difficult or impossible to absorb nutrients from the food you eat, which can make you very, very sick.
To diagnose celiac disease, your doctor will conduct a few blood tests. These don't diagnose you, however — they simply indicate whether or not you're more likely to have celiac disease. These tests, called antibody tests, can show if your immune system is having an abnormal response to gluten.
If one or more of these tests are positive, you will likely be scheduled for an intestinal biopsy, which is an invasive test requiring anesthesia. Biopsies, or tissue samples, will be removed and later examined under a microscope to see if there is evidence of villi damage. If there is, you will be granted a celiac disease diagnosis and be instructed to go gluten free for the rest of your life.
The real kicker? You have to be eating gluten while you are being tested using these methods, so if gluten is in fact making you sick, you have to keep doing it until you know for sure (and if you've stopped for any reason, you have to start back up again). In essence, you are hoping to damage yourself enough for a diagnosis through intestinal biopsy. Why? Because most doctors will not diagnose celiac disease without evidence of villi damage. According to the American College of Gastroenterology, "Upper endoscopy with small-bowel biopsy is a critical component of the diagnostic evaluation for persons with suspected CD and is recommended to confirm the diagnosis."
There are doctors who will diagnose a patient using different criteria, but the intestinal biopsy is still considered the gold standard, and will remain so unless another equally accurate test comes along.
This is why a simple, single blood test would be huge news. Not for people who have already gone down the diagnosis road, like my older daughter whose biopsy was positive nearly six years ago. But for all those children and adults well into the future who won't have to worry about going under anesthesia and having a biopsy performed.
Right now, we're patiently waiting through celiac testing for my younger daughter. She's showing similar symptoms as her sister did years ago, and when I took her to get screened, she was positive for one antibody. However, her biopsy was negative, so we're spending time feeding her gluten before her repeat blood tests later this year — essentially hoping that they either go down, or they go up enough that another biopsy would show the damage.
I've always thought celiac testing was pretty intense, but it is even more so now — now that I wonder if she even has it, and if so, I keep feeding her things that might possibly be making her sicker, which makes me feel badly.
She likely won't benefit from this new blood test but it makes my heart happy that someday, a kid won't have to go through what she's going through just to get a diagnosis.
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