{"id":273,"date":"2017-11-15T21:24:58","date_gmt":"2017-11-15T21:24:58","guid":{"rendered":"http:\/\/www.sudweeksfamily.com\/celiac\/?page_id=273"},"modified":"2017-11-17T15:40:53","modified_gmt":"2017-11-17T15:40:53","slug":"testing","status":"publish","type":"page","link":"https:\/\/www.sudweeksfamily.com\/celiac\/testing\/","title":{"rendered":"Physical Exams and Testing"},"content":{"rendered":"<p><em>This site is intended to share the answers I found in my quest to understand celiac disease with family,\u00a0 friends, and others who may be trying to find the answers I too have been seeking. This is a compilation of answers from various sources (clearly listed and linked prior to the quotes).<\/em><\/p>\n<h3>What tests can be run to diagnose celiac disease?<\/h3>\n<p>(Source:\u00a0<a href=\"http:\/\/www.bidmc.org\/Centers-and-Departments\/Departments\/Digestive-Disease-Center\/Services\/Celiac-Center\/FAQ\/Diagnosing-Celiac-Disease.aspx#bloodtests\" target=\"_blank\" rel=\"noopener\">Beth Israel Deaconess Medical Center, Harvard Medical School Teaching Hospital: FAQ &#8211; How is celiac disease diagnosed?<\/a>)<\/p>\n[<em>It is important to note that one should not start a gluten-free diet before having these tests.<\/em>]\n<p>&nbsp;<\/p>\n\t\t\t\t\t\t<style>\r\n\t\t\t\t#wpsm_accordion_274 .wpsm_panel-heading{\r\n\tpadding:0px !important;\r\n}\r\n#wpsm_accordion_274 .wpsm_panel-title {\r\n\tmargin:0px !important; \r\n\ttext-transform:none !important;\r\n\tline-height: 1 !important;\r\n}\r\n#wpsm_accordion_274 .wpsm_panel-title a{\r\n\ttext-decoration:none;\r\n\toverflow:hidden;\r\n\tdisplay:block;\r\n\tpadding:0px;\r\n\tfont-size: 18px !important;\r\n\tfont-family: Open Sans !important;\r\n\tcolor:#000000 !important;\r\n\tborder-bottom:0px !important;\r\n}\r\n\r\n#wpsm_accordion_274 .wpsm_panel-title a:focus {\r\noutline: 0px !important;\r\n}\r\n\r\n#wpsm_accordion_274 .wpsm_panel-title a:hover, #wpsm_accordion_274 .wpsm_panel-title a:focus {\r\n\tcolor:#000000 !important;\r\n}\r\n#wpsm_accordion_274 .acc-a{\r\n\tcolor: #000000 !important;\r\n\tbackground-color:#e8e8e8 !important;\r\n\tborder-color: #ddd;\r\n}\r\n#wpsm_accordion_274 .wpsm_panel-default > .wpsm_panel-heading{\r\n\tcolor: #000000 !important;\r\n\tbackground-color: #e8e8e8 !important;\r\n\tborder-color: #e8e8e8 !important;\r\n\tborder-top-left-radius: 0px;\r\n\tborder-top-right-radius: 0px;\r\n}\r\n#wpsm_accordion_274 .wpsm_panel-default {\r\n\t\tborder:1px solid transparent !important;\r\n\t}\r\n#wpsm_accordion_274 {\r\n\tmargin-bottom: 20px;\r\n\toverflow: hidden;\r\n\tfloat: none;\r\n\twidth: 100%;\r\n\tdisplay: block;\r\n}\r\n#wpsm_accordion_274 .ac_title_class{\r\n\tdisplay: block;\r\n\tpadding-top: 12px;\r\n\tpadding-bottom: 12px;\r\n\tpadding-left: 15px;\r\n\tpadding-right: 15px;\r\n}\r\n#wpsm_accordion_274  .wpsm_panel {\r\n\toverflow:hidden;\r\n\t-webkit-box-shadow: 0 0px 0px rgba(0, 0, 0, .05);\r\n\tbox-shadow: 0 0px 0px rgba(0, 0, 0, .05);\r\n\t\tborder-radius: 4px;\r\n\t}\r\n#wpsm_accordion_274  .wpsm_panel + .wpsm_panel {\r\n\t\tmargin-top: 5px;\r\n\t}\r\n#wpsm_accordion_274  .wpsm_panel-body{\r\n\tbackground-color:#ffffff !important;\r\n\tcolor:#000000 !important;\r\n\tborder-top-color: #e8e8e8 !important;\r\n\tfont-size:16px !important;\r\n\tfont-family: Open Sans !important;\r\n\toverflow: hidden;\r\n\t\tborder: 2px solid #e8e8e8 !important;\r\n\t}\r\n\r\n#wpsm_accordion_274 .ac_open_cl_icon{\r\n\tbackground-color:#e8e8e8 !important;\r\n\tcolor: #000000 !important;\r\n\tfloat:right !important;\r\n\tpadding-top: 12px !important;\r\n\tpadding-bottom: 12px !important;\r\n\tline-height: 1.0 !important;\r\n\tpadding-left: 15px !important;\r\n\tpadding-right: 15px !important;\r\n\tdisplay: inline-block !important;\r\n}\r\n\r\n\t\t\t\r\n\t\t\t\t\r\n\t\r\n\t\t\t<\/style>\r\n\t\t\t<div class=\"wpsm_panel-group\" id=\"wpsm_accordion_274\" >\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t<!-- Inner panel Start -->\r\n\t\t\t\t\t<div class=\"wpsm_panel wpsm_panel-default\">\r\n\t\t\t\t\t\t<div class=\"wpsm_panel-heading\" role=\"tab\" >\r\n\t\t\t\t\t\t  <h4 class=\"wpsm_panel-title\">\r\n\t\t\t\t\t\t\t<a  class=\"\"  data-toggle=\"collapse\" data-parent=\"#wpsm_accordion_274 \" href=\"#ac_274_collapse1\"  >\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ac_open_cl_icon fa fa-plus\"><\/span>\r\n\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t \r\n\t\t\t\t\t\t\t\t<span class=\"ac_title_class\">\r\n\t\t\t\t\t\t\t\t\tRecommended blood tests for celiac diagnosis\t\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t<\/a>\r\n\t\t\t\t\t\t  <\/h4>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t<div id=\"ac_274_collapse1\" class=\"wpsm_panel-collapse collapse \"  >\r\n\t\t\t\t\t\t  <div class=\"wpsm_panel-body\">\r\n\t\t\t\t\t\t\t\u2022\tIgA-tTG and total IgA: Currently, the most frequently used test is IgA anti-tTG, or tissue transglutaminase.<br>\r\nThe tTG IgA test will be positive (>19) in about 98% of patients with CD that have been on a gluten containing diet. We call this number the test\u2019s sensitivity. The same test will come back negative (<20) in about 95% of healthy people without CD. We call this the test\u2019s specificity.<br>\r\n\u2022\tTotal IgA: Your doctor may additionally check your total IgA level to determine if you have an IgA deficiency, which is a harmless condition that is associated with CD. If someone is IgA deficient, they may have a false negative result to their EMA or tTG tests. In this case, your doctor can order a DGP test. He\/she could also order an IgG tTG test instead, although this is slightly less accurate than IgA tTG.<br>\r\n\u2022\tDGP: (deamidated gliadin peptide) There are occasional individuals whose IgA-tTG results may be misleading. In this case, we recommend using a newer test, anti-DGP (IgG and IgA antibodies to deamidated gliadin peptide). It is similarly accurate to IgA-tTG and is useful for patients with IgA deficiency. <br>\r\n\u2022\tEMA: Another blood test that your doctor may order is an EMA, or endomysial antibody test. This test is used less frequently than the IgA anti-tTG, but since it detects the same target antigen on a tissue section it can be just as accurate.<br>\r\n\u2022\tAGA: Anti-gliadin antibodies, or AGA, were used in the past, but are typically not routinely checked now because they are much less accurate than tTG or EMA.\r\n\t\t\t\t\t\t  <\/div>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<!-- Inner panel End -->\r\n\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t<!-- Inner panel Start -->\r\n\t\t\t\t\t<div class=\"wpsm_panel wpsm_panel-default\">\r\n\t\t\t\t\t\t<div class=\"wpsm_panel-heading\" role=\"tab\" >\r\n\t\t\t\t\t\t  <h4 class=\"wpsm_panel-title\">\r\n\t\t\t\t\t\t\t<a  class=\"collapsed\"  data-toggle=\"collapse\" data-parent=\"#wpsm_accordion_274 \" href=\"#ac_274_collapse2\"  >\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ac_open_cl_icon fa fa-plus\"><\/span>\r\n\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t \r\n\t\t\t\t\t\t\t\t<span class=\"ac_title_class\">\r\n\t\t\t\t\t\t\t\t\tEndoscopy &amp; biopsy for diagnosis\t\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t<\/a>\r\n\t\t\t\t\t\t  <\/h4>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t<div id=\"ac_274_collapse2\" class=\"wpsm_panel-collapse collapse \"  >\r\n\t\t\t\t\t\t  <div class=\"wpsm_panel-body\">\r\n\t\t\t\t\t\t\tA doctor will look at the tissue under a microscope to determine whether there is damage to the intestine that is characteristic of CD.\t\t\t\t\t\t  <\/div>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<!-- Inner panel End -->\r\n\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t<!-- Inner panel Start -->\r\n\t\t\t\t\t<div class=\"wpsm_panel wpsm_panel-default\">\r\n\t\t\t\t\t\t<div class=\"wpsm_panel-heading\" role=\"tab\" >\r\n\t\t\t\t\t\t  <h4 class=\"wpsm_panel-title\">\r\n\t\t\t\t\t\t\t<a  class=\"collapsed\"  data-toggle=\"collapse\" data-parent=\"#wpsm_accordion_274 \" href=\"#ac_274_collapse3\"  >\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ac_open_cl_icon fa fa-plus\"><\/span>\r\n\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t \r\n\t\t\t\t\t\t\t\t<span class=\"ac_title_class\">\r\n\t\t\t\t\t\t\t\t\tGene testing\t\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t<\/a>\r\n\t\t\t\t\t\t  <\/h4>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t<div id=\"ac_274_collapse3\" class=\"wpsm_panel-collapse collapse \"  >\r\n\t\t\t\t\t\t  <div class=\"wpsm_panel-body\">\r\n\t\t\t\t\t\t\tIf your doctor is still uncertain as to whether or not you have CD, s\/he may order an HLA-DQ2 or HLA-DQ8 blood test. This is a genetic test that will help her\/him determine whether or not you have CD. \t\t\t\t\t\t  <\/div>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<!-- Inner panel End -->\r\n\t\t\t\t\t\r\n\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\n<p>&nbsp;<\/p>\n<h3>What tests might be run to identify problems caused\/influenced by celiac disease?<\/h3>\n<p>(<em>Or some of these test results might lead to a diagnosis celiac disease.<\/em>)<\/p>\n<p>(Source:\u00a0<a href=\"http:\/\/www.bidmc.org\/Centers-and-Departments\/Departments\/Digestive-Disease-Center\/Services\/Celiac-Center\/FAQ\/Diagnosing-Celiac-Disease.aspx#bloodtests\" target=\"_blank\" rel=\"noopener\">Beth Israel Deaconess Medical Center, Harvard Medical School Teaching Hospital: FAQ &#8211; How is celiac disease diagnosed?<\/a>)<\/p>\n<p>&#8220;Depending on the patient&#8217;s particular symptoms and medical history, a number of physical examinations and lab studies may be carried out to help identify nutritional deficiencies, electrolyte abnormalities or other health concerns.&#8221;<\/p>\n\t\t\t\t\t\t<style>\r\n\t\t\t\t#wpsm_accordion_275 .wpsm_panel-heading{\r\n\tpadding:0px !important;\r\n}\r\n#wpsm_accordion_275 .wpsm_panel-title {\r\n\tmargin:0px !important; \r\n\ttext-transform:none !important;\r\n\tline-height: 1 !important;\r\n}\r\n#wpsm_accordion_275 .wpsm_panel-title a{\r\n\ttext-decoration:none;\r\n\toverflow:hidden;\r\n\tdisplay:block;\r\n\tpadding:0px;\r\n\tfont-size: 18px !important;\r\n\tfont-family: Open Sans !important;\r\n\tcolor:#000000 !important;\r\n\tborder-bottom:0px !important;\r\n}\r\n\r\n#wpsm_accordion_275 .wpsm_panel-title a:focus {\r\noutline: 0px !important;\r\n}\r\n\r\n#wpsm_accordion_275 .wpsm_panel-title a:hover, #wpsm_accordion_275 .wpsm_panel-title a:focus {\r\n\tcolor:#000000 !important;\r\n}\r\n#wpsm_accordion_275 .acc-a{\r\n\tcolor: #000000 !important;\r\n\tbackground-color:#e8e8e8 !important;\r\n\tborder-color: #ddd;\r\n}\r\n#wpsm_accordion_275 .wpsm_panel-default > .wpsm_panel-heading{\r\n\tcolor: #000000 !important;\r\n\tbackground-color: #e8e8e8 !important;\r\n\tborder-color: #e8e8e8 !important;\r\n\tborder-top-left-radius: 0px;\r\n\tborder-top-right-radius: 0px;\r\n}\r\n#wpsm_accordion_275 .wpsm_panel-default {\r\n\t\tborder:1px solid transparent !important;\r\n\t}\r\n#wpsm_accordion_275 {\r\n\tmargin-bottom: 20px;\r\n\toverflow: hidden;\r\n\tfloat: none;\r\n\twidth: 100%;\r\n\tdisplay: block;\r\n}\r\n#wpsm_accordion_275 .ac_title_class{\r\n\tdisplay: block;\r\n\tpadding-top: 12px;\r\n\tpadding-bottom: 12px;\r\n\tpadding-left: 15px;\r\n\tpadding-right: 15px;\r\n}\r\n#wpsm_accordion_275  .wpsm_panel {\r\n\toverflow:hidden;\r\n\t-webkit-box-shadow: 0 0px 0px rgba(0, 0, 0, .05);\r\n\tbox-shadow: 0 0px 0px rgba(0, 0, 0, .05);\r\n\t\tborder-radius: 4px;\r\n\t}\r\n#wpsm_accordion_275  .wpsm_panel + .wpsm_panel {\r\n\t\tmargin-top: 5px;\r\n\t}\r\n#wpsm_accordion_275  .wpsm_panel-body{\r\n\tbackground-color:#ffffff !important;\r\n\tcolor:#000000 !important;\r\n\tborder-top-color: #e8e8e8 !important;\r\n\tfont-size:16px !important;\r\n\tfont-family: Open Sans !important;\r\n\toverflow: hidden;\r\n\t\tborder: 2px solid #e8e8e8 !important;\r\n\t}\r\n\r\n#wpsm_accordion_275 .ac_open_cl_icon{\r\n\tbackground-color:#e8e8e8 !important;\r\n\tcolor: #000000 !important;\r\n\tfloat:right !important;\r\n\tpadding-top: 12px !important;\r\n\tpadding-bottom: 12px !important;\r\n\tline-height: 1.0 !important;\r\n\tpadding-left: 15px !important;\r\n\tpadding-right: 15px !important;\r\n\tdisplay: inline-block !important;\r\n}\r\n\r\n\t\t\t\r\n\t\t\t\t\r\n\t\r\n\t\t\t<\/style>\r\n\t\t\t<div class=\"wpsm_panel-group\" id=\"wpsm_accordion_275\" >\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t<!-- Inner panel Start -->\r\n\t\t\t\t\t<div class=\"wpsm_panel wpsm_panel-default\">\r\n\t\t\t\t\t\t<div class=\"wpsm_panel-heading\" role=\"tab\" >\r\n\t\t\t\t\t\t  <h4 class=\"wpsm_panel-title\">\r\n\t\t\t\t\t\t\t<a  class=\"\"  data-toggle=\"collapse\" data-parent=\"#wpsm_accordion_275 \" href=\"#ac_275_collapse1\"  >\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ac_open_cl_icon fa fa-plus\"><\/span>\r\n\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t \r\n\t\t\t\t\t\t\t\t<span class=\"ac_title_class\">\r\n\t\t\t\t\t\t\t\t\tPossible physical exam findings\t\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t<\/a>\r\n\t\t\t\t\t\t  <\/h4>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t<div id=\"ac_275_collapse1\" class=\"wpsm_panel-collapse collapse \"  >\r\n\t\t\t\t\t\t  <div class=\"wpsm_panel-body\">\r\n\t\t\t\t\t\t\t\u2022\tExamination of the abdomen may reveal a bloated stomach due to swelling of intestinal loops with fluids and gas <br>\r\n\u2022\tSigns of weight loss such as muscle atrophy (loss of muscle mass) or loose skin folds<br> \r\n\u2022\tOrthostatic hypotension (a decrease in blood pressure when going from a seated or lying position to standing) <br>\r\n\u2022\tPeripheral edema (a collection of fluids in the arms and legs) <br>\r\n\u2022\tBruising<br>\r\n\u2022\tDermatitis Herpetiformis (DH) (see section on DH)<br>\r\n\u2022\tCheilosis (severely reddened and cracked lips; most commonly seen at the corners of the mouth)<br>\r\n\u2022\tGlossitis (inflammation of the tongue with formation of ulcers in the mouth)<br>\r\n\u2022\tPeripheral neuropathy (decreased sensation or numbness in the fingers and toes)<br>\r\n\u2022\tPhysical exam findings related to hypocalcemia\r\n(Chvostek's sign: tapping on a specific area of the face results in twitching of the facial muscle; \r\nTrousseau's sign: inflation of a blood pressure cuff on either arm results in a \"carpal spasm,\" seen as flexing of the wrist)\r\n\t\t\t\t\t\t  <\/div>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<!-- Inner panel End -->\r\n\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t<!-- Inner panel Start -->\r\n\t\t\t\t\t<div class=\"wpsm_panel wpsm_panel-default\">\r\n\t\t\t\t\t\t<div class=\"wpsm_panel-heading\" role=\"tab\" >\r\n\t\t\t\t\t\t  <h4 class=\"wpsm_panel-title\">\r\n\t\t\t\t\t\t\t<a  class=\"collapsed\"  data-toggle=\"collapse\" data-parent=\"#wpsm_accordion_275 \" href=\"#ac_275_collapse2\"  >\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ac_open_cl_icon fa fa-plus\"><\/span>\r\n\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t \r\n\t\t\t\t\t\t\t\t<span class=\"ac_title_class\">\r\n\t\t\t\t\t\t\t\t\tBlood tests\t\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t<\/a>\r\n\t\t\t\t\t\t  <\/h4>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t<div id=\"ac_275_collapse2\" class=\"wpsm_panel-collapse collapse \"  >\r\n\t\t\t\t\t\t  <div class=\"wpsm_panel-body\">\r\n\t\t\t\t\t\t\t\u2022\tLow iron levels are common. (Ferritin is generally the best test to measure iron stores., Iron)<br>\r\n\u2022\tB12 and folate: Anemia due to deficiency in iron, folate and, in rare cases, vitamin B12 may be present.<br>\r\n\u2022\tVitamin D (25-OHD)<br>\r\n\u2022\tZinc\r\n\t\t\t\t\t\t  <\/div>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<!-- Inner panel End -->\r\n\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t<!-- Inner panel Start -->\r\n\t\t\t\t\t<div class=\"wpsm_panel wpsm_panel-default\">\r\n\t\t\t\t\t\t<div class=\"wpsm_panel-heading\" role=\"tab\" >\r\n\t\t\t\t\t\t  <h4 class=\"wpsm_panel-title\">\r\n\t\t\t\t\t\t\t<a  class=\"collapsed\"  data-toggle=\"collapse\" data-parent=\"#wpsm_accordion_275 \" href=\"#ac_275_collapse3\"  >\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ac_open_cl_icon fa fa-plus\"><\/span>\r\n\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t \r\n\t\t\t\t\t\t\t\t<span class=\"ac_title_class\">\r\n\t\t\t\t\t\t\t\t\tOther possible tests (depending on condition of patient)\t\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t<\/a>\r\n\t\t\t\t\t\t  <\/h4>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t<div id=\"ac_275_collapse3\" class=\"wpsm_panel-collapse collapse \"  >\r\n\t\t\t\t\t\t  <div class=\"wpsm_panel-body\">\r\n\t\t\t\t\t\t\t\u2022\tParathyroid hormone<br>\r\n\u2022\tTSH (thyroid stimulating hormone)<br>\r\n\u2022\tPotassium<br>\r\n\u2022\tSerum calcium<br>\r\n\u2022\tMagnesium<br>\r\n\u2022\tFat soluble vitamins (with diarrhea)<br>\r\n\u2022\tCarnitine<br>\r\n\u2022\tAlbumin (protein stores) if malnutrition is suspected<br>\r\n\u2022\tCholesterol panel\t\t\t\t\t\t  <\/div>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<!-- Inner panel End -->\r\n\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t<!-- Inner panel Start -->\r\n\t\t\t\t\t<div class=\"wpsm_panel wpsm_panel-default\">\r\n\t\t\t\t\t\t<div class=\"wpsm_panel-heading\" role=\"tab\" >\r\n\t\t\t\t\t\t  <h4 class=\"wpsm_panel-title\">\r\n\t\t\t\t\t\t\t<a  class=\"collapsed\"  data-toggle=\"collapse\" data-parent=\"#wpsm_accordion_275 \" href=\"#ac_275_collapse4\"  >\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ac_open_cl_icon fa fa-plus\"><\/span>\r\n\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t \r\n\t\t\t\t\t\t\t\t<span class=\"ac_title_class\">\r\n\t\t\t\t\t\t\t\t\tImaging studies\t\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t<\/a>\r\n\t\t\t\t\t\t  <\/h4>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t<div id=\"ac_275_collapse4\" class=\"wpsm_panel-collapse collapse \"  >\r\n\t\t\t\t\t\t  <div class=\"wpsm_panel-body\">\r\n\t\t\t\t\t\t\tImaging studies including x-rays, CT scans, and a variety of other tests are rarely necessary in the diagnosis of celiac disease. However, they may be needed to rule out other disorders in cases where the diagnosis is uncertain or to assess for complications of celiac disease.<br>\r\n\u2022\tX-rays of the small bowel can be taken after the patient swallows a substance known as barium. On the X-ray, the doctor may observe dilatation of the small intestine or an absence of the normal pattern of the small intestine due to destruction of the villi. Similarly, abdominal ultrasound has also been used to suggest the diagnosis of celiac disease but at this time imaging studies are not routinely recommended in the diagnosis and follow up of celiac disease.<br>\r\n\u2022\tBone density studies (also referred to as a DEXA scan) should be performed in those recently diagnosed with celiac disease. DEXA scans are usually recommended after 12 months of strictly following a gluten-free diet.\r\n\t\t\t\t\t\t  <\/div>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<!-- Inner panel End -->\r\n\t\t\t\t\t\r\n\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\n<p>More on:\u00a0<a href=\"http:\/\/www.bidmc.org\/~\/media\/Files\/Centers%20and%20Departments\/DigestiveDiseaseCenter\/CeliacNow\/DOCS\/Genetics_Level2.pdf\" target=\"_blank\" rel=\"noopener\">Genetics (Gene Testing)<\/a>\u00a0(Beth Israel Deaconess Medical Center, Harvard Medical School Teaching Hospital)<\/p>\n<h3>Genetic FAQs<\/h3>\n<p>(Source:\u00a0<a href=\"http:\/\/www.bidmc.org\/Centers-and-Departments\/Departments\/Digestive-Disease-Center\/Services\/Celiac-Center\/FAQ\/Diagnosing-Celiac-Disease.aspx#bloodtests\" target=\"_blank\" rel=\"noopener\">Beth Israel Deaconess Medical Center, Harvard Medical School Teaching Hospital: FAQs<\/a>)<\/p>\n\t\t\t\t\t\t<style>\r\n\t\t\t\t#wpsm_accordion_376 .wpsm_panel-heading{\r\n\tpadding:0px !important;\r\n}\r\n#wpsm_accordion_376 .wpsm_panel-title {\r\n\tmargin:0px !important; \r\n\ttext-transform:none !important;\r\n\tline-height: 1 !important;\r\n}\r\n#wpsm_accordion_376 .wpsm_panel-title a{\r\n\ttext-decoration:none;\r\n\toverflow:hidden;\r\n\tdisplay:block;\r\n\tpadding:0px;\r\n\tfont-size: 18px !important;\r\n\tfont-family: Open Sans !important;\r\n\tcolor:#000000 !important;\r\n\tborder-bottom:0px !important;\r\n}\r\n\r\n#wpsm_accordion_376 .wpsm_panel-title a:focus {\r\noutline: 0px !important;\r\n}\r\n\r\n#wpsm_accordion_376 .wpsm_panel-title a:hover, #wpsm_accordion_376 .wpsm_panel-title a:focus {\r\n\tcolor:#000000 !important;\r\n}\r\n#wpsm_accordion_376 .acc-a{\r\n\tcolor: #000000 !important;\r\n\tbackground-color:#e8e8e8 !important;\r\n\tborder-color: #ddd;\r\n}\r\n#wpsm_accordion_376 .wpsm_panel-default > .wpsm_panel-heading{\r\n\tcolor: #000000 !important;\r\n\tbackground-color: #e8e8e8 !important;\r\n\tborder-color: #e8e8e8 !important;\r\n\tborder-top-left-radius: 0px;\r\n\tborder-top-right-radius: 0px;\r\n}\r\n#wpsm_accordion_376 .wpsm_panel-default {\r\n\t\tborder:1px solid transparent !important;\r\n\t}\r\n#wpsm_accordion_376 {\r\n\tmargin-bottom: 20px;\r\n\toverflow: hidden;\r\n\tfloat: none;\r\n\twidth: 100%;\r\n\tdisplay: block;\r\n}\r\n#wpsm_accordion_376 .ac_title_class{\r\n\tdisplay: block;\r\n\tpadding-top: 12px;\r\n\tpadding-bottom: 12px;\r\n\tpadding-left: 15px;\r\n\tpadding-right: 15px;\r\n}\r\n#wpsm_accordion_376  .wpsm_panel {\r\n\toverflow:hidden;\r\n\t-webkit-box-shadow: 0 0px 0px rgba(0, 0, 0, .05);\r\n\tbox-shadow: 0 0px 0px rgba(0, 0, 0, .05);\r\n\t\tborder-radius: 4px;\r\n\t}\r\n#wpsm_accordion_376  .wpsm_panel + .wpsm_panel {\r\n\t\tmargin-top: 5px;\r\n\t}\r\n#wpsm_accordion_376  .wpsm_panel-body{\r\n\tbackground-color:#ffffff !important;\r\n\tcolor:#000000 !important;\r\n\tborder-top-color: #e8e8e8 !important;\r\n\tfont-size:16px !important;\r\n\tfont-family: Open Sans !important;\r\n\toverflow: hidden;\r\n\t\tborder: 2px solid #e8e8e8 !important;\r\n\t}\r\n\r\n#wpsm_accordion_376 .ac_open_cl_icon{\r\n\tbackground-color:#e8e8e8 !important;\r\n\tcolor: #000000 !important;\r\n\tfloat:right !important;\r\n\tpadding-top: 12px !important;\r\n\tpadding-bottom: 12px !important;\r\n\tline-height: 1.0 !important;\r\n\tpadding-left: 15px !important;\r\n\tpadding-right: 15px !important;\r\n\tdisplay: inline-block !important;\r\n}\r\n\r\n\t\t\t\r\n\t\t\t\t\r\n\t\r\n\t\t\t<\/style>\r\n\t\t\t<div class=\"wpsm_panel-group\" id=\"wpsm_accordion_376\" >\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t<!-- Inner panel Start -->\r\n\t\t\t\t\t<div class=\"wpsm_panel wpsm_panel-default\">\r\n\t\t\t\t\t\t<div class=\"wpsm_panel-heading\" role=\"tab\" >\r\n\t\t\t\t\t\t  <h4 class=\"wpsm_panel-title\">\r\n\t\t\t\t\t\t\t<a  class=\"\"  data-toggle=\"collapse\" data-parent=\"#wpsm_accordion_376 \" href=\"#ac_376_collapse1\"  >\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ac_open_cl_icon fa fa-plus\"><\/span>\r\n\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t \r\n\t\t\t\t\t\t\t\t<span class=\"ac_title_class\">\r\n\t\t\t\t\t\t\t\t\tWhat is the meaning of HLA-DQ2 and HLA-DQ8?\t\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t<\/a>\r\n\t\t\t\t\t\t  <\/h4>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t<div id=\"ac_376_collapse1\" class=\"wpsm_panel-collapse collapse \"  >\r\n\t\t\t\t\t\t  <div class=\"wpsm_panel-body\">\r\n\t\t\t\t\t\t\t\"HLA-DQ2 and HLA-DQ8 are the names of two genes which are part of the immune system and are able to stick to the gluten proteins. Every person with celiac disease (CD) has at least one of these genes. If your doctor is unsure as to whether or not you have CD, s\/he can perform a simple blood test to determine whether or not you have one or both of these genes. If you do not have one of these two genes, your doctor can rule out CD. If you DO have one of these genes, it is possible that you have or may develop CD. Your doctor will need to perform more tests. You do not need to eat gluten in order to have the gene testing. Visit Genetics under Medical Management on\u00a0www.celiacnow.org.\"\t\t\t\t\t\t  <\/div>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<!-- Inner panel End -->\r\n\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t<!-- Inner panel Start -->\r\n\t\t\t\t\t<div class=\"wpsm_panel wpsm_panel-default\">\r\n\t\t\t\t\t\t<div class=\"wpsm_panel-heading\" role=\"tab\" >\r\n\t\t\t\t\t\t  <h4 class=\"wpsm_panel-title\">\r\n\t\t\t\t\t\t\t<a  class=\"collapsed\"  data-toggle=\"collapse\" data-parent=\"#wpsm_accordion_376 \" href=\"#ac_376_collapse2\"  >\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ac_open_cl_icon fa fa-plus\"><\/span>\r\n\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t \r\n\t\t\t\t\t\t\t\t<span class=\"ac_title_class\">\r\n\t\t\t\t\t\t\t\t\tDo people with celiac disease (CD) have one or both of the genes, HLA-DQ2 and HLA-DQ8, passed down from their parents? How do you inherit these genes? Can a parent have gluten sensitivity and the son or daughter have CD?\t\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t<\/a>\r\n\t\t\t\t\t\t  <\/h4>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t<div id=\"ac_376_collapse2\" class=\"wpsm_panel-collapse collapse \"  >\r\n\t\t\t\t\t\t  <div class=\"wpsm_panel-body\">\r\n\t\t\t\t\t\t\t\"The Human Leukocyte Antigen (HLA) genes are linked to many autoimmune diseases such as CD. Everyone has a copy from the mother and a copy from the father. These copies can come in different versions called alleles. The HLA gene alleles that predispose to CD are called DQ2 and DQ8. One may have DQ2 or DQ8 in one of the copies or in both. People who have only one copy of DQ2 or DQ8 have a risk of about 3% of having CD, whereas people who have two copies of either have a risk around 10%.\u00a0\r\n<br><br>\r\n\"HLA types are actually combinations of genes so it is possible to be DQ2 positive even if neither of your parents has this gene. Overall though, at least 50% of children of parents carrying DQ2 or DQ8 will also have one of these. Almost all people with CD have at least one DQ2 or DQ8 copy. This is why genetic testing is so useful to rule out CD. Nevertheless, since 30-40% of the general population has at least one copy of DQ2 or DQ8, the gene test is not a good test to confirm CD. Visit Genetics under Medical Management on\u00a0www.celiacnow.org.\"\t\t\t\t\t\t  <\/div>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<!-- Inner panel End -->\r\n\t\t\t\t\t\r\n\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\n<p>&nbsp;<\/p>\n<h3>What future testing options are being researched?<\/h3>\n\t\t\t\t\t\t<style>\r\n\t\t\t\t#wpsm_accordion_407 .wpsm_panel-heading{\r\n\tpadding:0px !important;\r\n}\r\n#wpsm_accordion_407 .wpsm_panel-title {\r\n\tmargin:0px !important; \r\n\ttext-transform:none !important;\r\n\tline-height: 1 !important;\r\n}\r\n#wpsm_accordion_407 .wpsm_panel-title a{\r\n\ttext-decoration:none;\r\n\toverflow:hidden;\r\n\tdisplay:block;\r\n\tpadding:0px;\r\n\tfont-size: 18px !important;\r\n\tfont-family: Open Sans !important;\r\n\tcolor:#000000 !important;\r\n\tborder-bottom:0px !important;\r\n}\r\n\r\n#wpsm_accordion_407 .wpsm_panel-title a:focus {\r\noutline: 0px !important;\r\n}\r\n\r\n#wpsm_accordion_407 .wpsm_panel-title a:hover, #wpsm_accordion_407 .wpsm_panel-title a:focus {\r\n\tcolor:#000000 !important;\r\n}\r\n#wpsm_accordion_407 .acc-a{\r\n\tcolor: #000000 !important;\r\n\tbackground-color:#e8e8e8 !important;\r\n\tborder-color: #ddd;\r\n}\r\n#wpsm_accordion_407 .wpsm_panel-default > .wpsm_panel-heading{\r\n\tcolor: #000000 !important;\r\n\tbackground-color: #e8e8e8 !important;\r\n\tborder-color: #e8e8e8 !important;\r\n\tborder-top-left-radius: 0px;\r\n\tborder-top-right-radius: 0px;\r\n}\r\n#wpsm_accordion_407 .wpsm_panel-default {\r\n\t\tborder:1px solid transparent !important;\r\n\t}\r\n#wpsm_accordion_407 {\r\n\tmargin-bottom: 20px;\r\n\toverflow: hidden;\r\n\tfloat: none;\r\n\twidth: 100%;\r\n\tdisplay: block;\r\n}\r\n#wpsm_accordion_407 .ac_title_class{\r\n\tdisplay: block;\r\n\tpadding-top: 12px;\r\n\tpadding-bottom: 12px;\r\n\tpadding-left: 15px;\r\n\tpadding-right: 15px;\r\n}\r\n#wpsm_accordion_407  .wpsm_panel {\r\n\toverflow:hidden;\r\n\t-webkit-box-shadow: 0 0px 0px rgba(0, 0, 0, .05);\r\n\tbox-shadow: 0 0px 0px rgba(0, 0, 0, .05);\r\n\t\tborder-radius: 4px;\r\n\t}\r\n#wpsm_accordion_407  .wpsm_panel + .wpsm_panel {\r\n\t\tmargin-top: 5px;\r\n\t}\r\n#wpsm_accordion_407  .wpsm_panel-body{\r\n\tbackground-color:#ffffff !important;\r\n\tcolor:#000000 !important;\r\n\tborder-top-color: #e8e8e8 !important;\r\n\tfont-size:16px !important;\r\n\tfont-family: Open Sans !important;\r\n\toverflow: hidden;\r\n\t\tborder: 2px solid #e8e8e8 !important;\r\n\t}\r\n\r\n#wpsm_accordion_407 .ac_open_cl_icon{\r\n\tbackground-color:#e8e8e8 !important;\r\n\tcolor: #000000 !important;\r\n\tfloat:right !important;\r\n\tpadding-top: 12px !important;\r\n\tpadding-bottom: 12px !important;\r\n\tline-height: 1.0 !important;\r\n\tpadding-left: 15px !important;\r\n\tpadding-right: 15px !important;\r\n\tdisplay: inline-block !important;\r\n}\r\n\r\n\t\t\t\r\n\t\t\t\t\r\n\t\r\n\t\t\t<\/style>\r\n\t\t\t<div class=\"wpsm_panel-group\" id=\"wpsm_accordion_407\" >\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t<!-- Inner panel Start -->\r\n\t\t\t\t\t<div class=\"wpsm_panel wpsm_panel-default\">\r\n\t\t\t\t\t\t<div class=\"wpsm_panel-heading\" role=\"tab\" >\r\n\t\t\t\t\t\t  <h4 class=\"wpsm_panel-title\">\r\n\t\t\t\t\t\t\t<a  class=\"\"  data-toggle=\"collapse\" data-parent=\"#wpsm_accordion_407 \" href=\"#ac_407_collapse1\"  >\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ac_open_cl_icon fa fa-plus\"><\/span>\r\n\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t \r\n\t\t\t\t\t\t\t\t<span class=\"ac_title_class\">\r\n\t\t\t\t\t\t\t\t\tDGP Serological Test\t\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t<\/a>\r\n\t\t\t\t\t\t  <\/h4>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t<div id=\"ac_407_collapse1\" class=\"wpsm_panel-collapse collapse \"  >\r\n\t\t\t\t\t\t  <div class=\"wpsm_panel-body\">\r\n\t\t\t\t\t\t\t<a href=\"https:\/\/www.celiac.com\/articles\/22043\/1\/Is-DGP-Serological-Test-the-Wave-of-the-Future-for-Celiac-Disease-Testing\/Page1.html\" target=\u201d_blank\u201d>Is DGP Serological Test the Wave of the Future for Celiac Disease Testing?<\/a>\r\n<br><br>(Referenceing: <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/20136587\" target=\u201d_blank\u201d>NCBI: Old and new serological tests for celiac disease screening.<\/a>)\t\t\t\t\t\t  <\/div>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<!-- Inner panel End -->\r\n\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t<!-- Inner panel Start -->\r\n\t\t\t\t\t<div class=\"wpsm_panel wpsm_panel-default\">\r\n\t\t\t\t\t\t<div class=\"wpsm_panel-heading\" role=\"tab\" >\r\n\t\t\t\t\t\t  <h4 class=\"wpsm_panel-title\">\r\n\t\t\t\t\t\t\t<a  class=\"collapsed\"  data-toggle=\"collapse\" data-parent=\"#wpsm_accordion_407 \" href=\"#ac_407_collapse2\"  >\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ac_open_cl_icon fa fa-plus\"><\/span>\r\n\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t \r\n\t\t\t\t\t\t\t\t<span class=\"ac_title_class\">\r\n\t\t\t\t\t\t\t\t\tI-FABP levels\t\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t<\/a>\r\n\t\t\t\t\t\t  <\/h4>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t<div id=\"ac_407_collapse2\" class=\"wpsm_panel-collapse collapse \"  >\r\n\t\t\t\t\t\t  <div class=\"wpsm_panel-body\">\r\n\t\t\t\t\t\t\t\"Intestinal fatty acid binding protein (I-FABP) is a cytosolic protein that is release by necrotic enterocytes. I-FABP has previously been studied as a possible marker to evaluate mucosal damage. This protein has been proposed as a sensitive diagnostic test in the evaluation of ischemia in mechanical small bowel obstruction [42]. On the other hand, I-FABP has demonstrated a positive predictive value of 98% in children with a positive serological test for celiac disease [43]. I-FABP levels increased significantly after two weeks of gluten challenge, while lower levels of I-FABP were seen in individuals following two weeks on gluten withdrawal. I-FABP may be considered as a future diagnostic tool that could assist in the diagnosis of celiac disease.\" (Source: <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4324867\/\" target=\u201d_blank\u201d>The present and the future in the diagnosis and management of celiac disease<\/a>\t\t\t\t\t\t  <\/div>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<!-- Inner panel End -->\r\n\t\t\t\t\t\r\n\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\n<p>&nbsp;<\/p>\n<h3>Can some test results be negative and a person still have celiac disease?<\/h3>\n<h3><strong>One Interpretation:<\/strong><\/h3>\n<p>(Source: <a href=\"http:\/\/www.cureceliacdisease.org\/faq\/what-are-the-chances-of-having-a-high-ttg-and-a-negative-biopsy-even-though-i-have-a-child-who-was-biopsy-diagnosed-with-celiac-and-still-being-negative-for-the-disease\/\" target=\"_blank\" rel=\"noopener\">The University of Chicago Medicine Celiac Disease Center<\/a>)<\/p>\n<p><strong>What are the chances of having a high tTG and a negative biopsy\u2014even though I have a child who was biopsy-diagnosed with celiac\u2014and still being negative for the disease? <\/strong><\/p>\n<p>&#8220;It\u2019s possible to be truly negative with these facts, especially if the tTG are only mildly elevated. Also check the more specific EMA test. If it\u2019s positive, we would conclude you\u2019re a potential celiac, which means the disease is simply waiting to explode, and we\u2019d suggest a gluten-free diet. March, 2016&#8221;<\/p>\n<p>(<em>More about<\/em>: <a href=\"http:\/\/www.sudweeksfamily.com\/celiac\/potential-celiac\/\" target=\"_blank\" rel=\"noopener\">Potential Celiac)<\/a><\/p>\n<h3><strong>Another Interpretation:<\/strong><\/h3>\n<p>Excerpts from:\u00a0<a href=\"http:\/\/www.sudweeksfamily.com\/celiac\/fasano\/\" target=\"_blank\" rel=\"noopener\">Alessio Fasano &#8211; &#8220;Spectrum of Gluten-Related Disorders: People Shall Not Live by Bread Alone&#8221;<\/a><\/p>\n<p>(<em><a href=\"http:\/\/www.sudweeksfamily.com\/celiac\/fasano\/\" target=\"_blank\" rel=\"noopener\">Alessio Fasano<\/a>: the W. Allan Walker Chair of Pediatrics at Harvard Medical School; \u00a0Vice Chair of Basic, Translational, and Clinical Research and Division Chief of Pediatric Gastroenterology and Nutrition at the MassGeneral Hospital for Children in Boston &#8211; In 2000, the research team of Alessio Fasano discovered zonulin, which regulates the intestinal permeability. In 2003, he published the results of the epidemiological study that demonstrated the prevalence of celiac disease in the U.S. to be far higher than previously thought, at a rate of 1 in 133 persons. &#8211;<\/em> <a href=\"https:\/\/en.wikipedia.org\/wiki\/Alessio_Fasano\">https:\/\/en.wikipedia.org\/wiki\/Alessio_Fasano<\/a>)<\/p>\n<p>&#8220;If you go on a gluten free diet, that\u2019s the landmark treatment of Celiac Diseaes, you prevent this interplay between the genes and the environment, and you completely revert the autoimmune process because these people will have no symptoms anymore, the antibodies that you use for diagnosis will go back to normal, and the damage of the intestine, that\u2019s the landmark of the auto immune insult is gone.&#8221; \u2026<\/p>\n<p>&#8220;A matter of fact, contrary to the general wisdom, the most frequent way the disease presents itself nowadays is not diarrhea and thirty pounds weight loss.\u00a0 <strong>The most frequent way the disease presents itself today is with anemia and with that chronic fatigue.<\/strong> Some people that are diagnosed with fibromyalgia or chronic fatigue syndrome, they\u2026 this is the most frequent way the disease presents itself.\u00a0 Don\u2019t be surprised that this can happen because iron is absorbed in the very few inches in the very early part of the intestine.\u00a0 If that is gone, there is no backup.\u00a0 There is no other way to bring iron in. If you don\u2019t bring iron in, you develop anemia.\u00a0 You can have only this few inches damaged, the rest is spared, the culpability of the intestine to digest the absorbed food stuff is untouched, but you develop the other symptoms.\u00a0 So that should not be surprising.&#8221;<\/p>\n<p><em>Celiac disease \u2013 a clinical chameleon<\/em><\/p>\n<p><em>Gluten is misinterpreted as bacteria (28:00)<\/em><\/p>\n[<strong><em>Question asked at the end of his presentation<\/em>:<\/strong>]\n<h4>&#8220;Which test do you believe is the best marker, be it blood or be it biopsy?<\/h4>\n<p>**&#8221;In the past, the paradigm to make diagnose Celiac disease was to fulfil five criteria. You have signs or symptoms of Celiac disease.\u00a0 You have the antibodies test positive. You have to have the HLA, genetically compatible.\u00a0 You have to have the damage of the intestine show the auto immune attack.\u00a0 And the symptoms, they need to go away when you embrace a gluten free diet.\u00a0 Eighty percent of people with Celiac disease will fulfil all five criteria, but there are exceptions.\u00a0 There are people who have no symptoms and yet they have Celiac disease.\u00a0 There are rare ten percent of people that that may have Celiac disease with negative antibodies.\u00a0 Extremely more rare, one percent of the people that can have Celiac disease without the problem HLA genes.\u00a0 Ten, fifteen percent of the time that we do that we do an endoscopy, we don\u2019t find the damage because either the diletion (??) is patchy or it\u2019s too far for the endoscope to reach. And we know well that some people on a gluten free diet for months and months, the symptoms will not go away.\u00a0 So there are exceptions.\u00a0 <strong>And based on that, we propose, and now it\u2019s been embraced by the scientific community, that if four out of the five criteria will do it.<\/strong>\u00a0 So if you have signs or symptoms of Celiac disease, strongly positive antibodies, compatible HLA, you can go on a gluten free diet without doing endoscopy.\u00a0 If the symptoms go away and the antibodies will go away on a gluten free diet, that diagnosis is confirmed even without the endoscopy.\u00a0 But you have to fulfil four out of five criteria.&#8221;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>This site is intended to share the answers I found in my quest to understand celiac disease with family,\u00a0 friends, [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"footnotes":""},"class_list":["post-273","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.sudweeksfamily.com\/celiac\/wp-json\/wp\/v2\/pages\/273","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.sudweeksfamily.com\/celiac\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.sudweeksfamily.com\/celiac\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.sudweeksfamily.com\/celiac\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.sudweeksfamily.com\/celiac\/wp-json\/wp\/v2\/comments?post=273"}],"version-history":[{"count":16,"href":"https:\/\/www.sudweeksfamily.com\/celiac\/wp-json\/wp\/v2\/pages\/273\/revisions"}],"predecessor-version":[{"id":408,"href":"https:\/\/www.sudweeksfamily.com\/celiac\/wp-json\/wp\/v2\/pages\/273\/revisions\/408"}],"wp:attachment":[{"href":"https:\/\/www.sudweeksfamily.com\/celiac\/wp-json\/wp\/v2\/media?parent=273"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}