Celiac disease is caused by an abnormal, autoimmune reaction to the protein gluten- a pasty, gluey substance that gives wheat-containing products their texture. “Gluey” is indeed an apt definition because the word is derived from the Latin word “glue”.  Any of us who are not gluten intolerant or Celiac (or gluten sensitive) will know just what a great difference gluten makes to texture and taste of food especially if they have tasted the gluten-free versions. But for those people who have an abnormal response to gluten containing foods, eating gluten may not be an option despite the better taste and texture. The discomfort and pain it may cause them makes wheat and gluten a total no-no. Celiac disease affects the small intestine, causing irritation and inflammation. Over the years, the lining of the intestine wares away which results in malabsorption of nutrients, constipation, anemia and other conditions.

Diagnosing the disease

Celiac disease can be diagnosed by doing a blood test or a DNA test. Analysis of blood of somebody suffering from Celiac disease will show high levels of antibodies in the blood. However, in order to have any result, it is important that the person taking the blood test eats gluten-containing products beforehand. This will trigger the autoimmune response and the release of the antibodies characteristic of Celiac disease.

If blood tests confirm you are actually celiac, doctors might suggest you undergo a biopsy to assess the extent of the damage done to the intestinal tract.

Genetic testing can also be carried out for celiac disease. A number of companies offer a genetic predisposition test which can include testing for Celiac disease. Such companies include easyDNA Ca, The Genetic Testing Laboratory and others. There are certain genes that have been implicated in Celiac diseases, of which presence can be confirmed by DNA testing (a DNA test does not seek to locate the presence of antibodies in the sample provided but seeks to confirm whether or not certain genes associated with gluten are present). The main advantage of a genetic test is that it can provide a positive result even if the person has been on a gluten-free diet. These genes are the following:

HLA-DQ2 – Human Leukocyte Antigen DQ2 (around 90% of Celiac sufferers have this gene). People can have either just a single copy of this gene or two copies. People with two copies have an even more elevated risk of being Celiacs than people with just one copy.

HLA-DQ8 – Human Leukocyte Antigen DQ8 (a much less common Celiac-associated gene which is present in only around 10% of people with the disease). People who have just a single copy of HLA-DQ8 are less likely to be Celiac than those who inherit 2 copies.

To be noted that we all inherit the HLA-DQ genes. HLA-DQ2 and HLA-DQ8 are genetic variations which are linked to celiac disease. People who are not celiac will be HLA-DQ2 negative or HLA DQ8 negative.

Gluten intolerant or Celiac?

You could be gluten-sensitive but not fully gluten intolerant or Celiac. If you are gluten sensitive you can tolerate gluten containing products to some extent but would need to avoid then where possible. Someone who is gluten sensitive will not suffer the same intensity of symptoms following ingestion of gluten that someone who is Celiac will.

To note that people often interchange gluten sensitivity with gluten intolerance but being fully intolerant to gluten would most likely mean you are Celiac.

Wheat Allergy – Am I Celiac?

An allergy to wheat does not constitute Celiac disease although it still does present dietary complications due to the widespread use of wheat, wheat containing products and wheat contaminated products. People with a wheat allergy, unlike Celiac sufferers, might be fine ingesting other grains such as barley or oats. Celiac disease is specifically caused when the body reacts to the presence of the protein gluten. However, in people with a wheat allergy, the body’s reaction could be due to one of a number of different wheat components. Whether suffering Celiac disease or from a wheat allergy, the sufferer must be extremely aware of what they are eating. Foods that might be gluten-free might still contain flour and gluten is a hidden ingredient in many foods and products including some medicines, soy sauce, kamut, Durum, beer, processed meats and sausages  and the list goes on.

Important points about Genetic Health Testing

There are various DNA tests for Celiac disease. Some of these will simply determine your genetic susceptibility; they would analyze your DNA to confirm the presence of the genes that would predispose someone to Celiac disease. Basically, a genetic predisposition test for celiac susceptibility will confirm how likely you are to develop Celiac disease. It will not give you a definite answer. The test might show you have a high predisposition to Celiac disease but it cannot accurately state that you will develop the disease. However, if the H.L.A. DQ2/DQ8 genetic test does not confirm the presence of the genes, the person who has undergone the test can have their mind at rest that they are not Celiac.

Unfortunately, a blood test or genetic health test will not confirm whether you are just gluten sensitive. In fact, a celiac blood test on a gluten-sensitive person could provide negative results. This is because in gluten –sensitive people the autoimmune response is not strong enough to be detected by a blood test. The only way for a gluten sensitive person to see whether they are in fact truly sensitive to gluten is by eliminating gluten containing products and see how they feel.