Coeliac Disease Tests

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Formal name: Gluten-Sensitive Enteropathy Tests
Related tests: FBC, ESR, CRP, Calcium, Total Protein, Albumin, Vitamin D, Vitamin B12, Vitamin E, Iron, Folate, Anti-Endomysial Antibodies (EMA), Anti-tissue Transglutaminase Antibody (TTG)

At a Glance

Why Get Tested?

To help in making a diagnosis of coeliac disease, and also to assess the effectiveness and degree of adherence to a gluten-free diet

When to Get Tested?

Patients who have symptoms suggestive of coeliac disease should be tested. These symptoms may include, for example:

  • chronic diarrhoea
  • abdominal pain
  • weight loss
  • anaemia
  • poor growth or chronic irritability in an infant or child

Patients with known coeliac disease may be tested by their doctor to help assess the effectiveness and observance of a gluten-free diet.

Sample Required?

A blood sample taken from a vein in your arm

Test Preparation Needed?

Follow your doctor's instructions. For diagnosis, ingestion of gluten-containing foods for a time period, such as several weeks, is necessary. For monitoring, no preparation is necessary.

The Test Sample

What is being tested?

Coeliac antibody tests help in the diagnosis of coeliac disease, and also can help to rule out this diagnosis. These tests detect autoantibodies that the body creates as part of an immune response to dietary proteins (such as gluten) found in wheat, rye, and barley. These autoantibodies are involved in inflammation in the gut and damage to the lining of the gut wall. This damage results in symptoms associated with malnutrition and malabsorption, such as

  • abdominal pain
  • abdominal bloating/distension
  • chronic diarrhoea
  • weight loss
  • oral ulceration
  • weakness
  • fatigue
  • anaemia
  • bleeding tendency
  • bone and joint pain
  • irritability and delayed growth and development in infants & children

Patients with coeliac disease will not typically have all of these symptoms, but may have a selection from this list. None of these symptoms are diagnostic of coeliac disease, as they can be found in other (gut) conditions.

A number of autoantibodies not normally present in the blood may be detected in sufferers of this condition:

  • Anti-tissue Transglutaminase Antibody (TTG), IgA: Tissue transglutaminase is an enzyme responsible for crosslinking (joining) certain proteins, and is found in the gut as well as in other tissues. It has been identified as the target molecule for the anti-endomysial antibodies. Although 'tissue' is in the name of this autoantibody, it nevertheless involves testing blood and not tissue.
  • Anti-Endomysial Antibodies (EMA): Endomysium is the thin connective tissue layer that covers individual muscle fibres. Anti-endomysial antibodies develop as part of the ongoing damage to the intestinal lining.
  • Anti-gliadin and anti-reticulin antibodies are autoantibodies that have been used to evaluate suspected celiac disease in the past. However these tests have both been superceded by anti-EMA and anti-TTG antibodies and are no longer used in the UK.

There are 5 types of antibody (IgG, IgA, IgM, IgD and IgE) in the body. Both IgG and IgA types of each autoantibody will often be present in the blood, and may be tested for. In many laboratories IgA antibodies are used as the first line test for coeliac disease, with other antibody tests being performed only when required.

In the past, the only way to diagnose coeliac disease was to take a biopsy (small piece of tissue) from the small intestine and to examine it under the microscope. This method is still used to confirm a diagnosis of coeliac disease, but the availability of less invasive blood tests used to screen for coeliac disease has reduced the number of biopsies required for this purpose.

How is the sample collected for testing?

A blood sample is obtained by inserting a needle into a vein in the arm.

NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.

Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.

Is any test preparation needed to ensure the quality of the sample?

Follow your doctor's instructions. For diagnosis, ingestion of gluten-containing foods for a time period, such as several weeks, is necessary. For monitoring, no preparation is necessary.

The Test

Common Questions

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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.