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celiac disease
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celiac disease

I've been having rib/abdominal pain on and off for about 9 years. dr's don't seem to know what causes it and many just write it off... its as if since they don't know what causes it it must not exist... anyway, my husband knows a dr in germany and he suggested I get tested for celiac disease... its gluten intolerance... it doesn't seem to matter what I eat or don't eat and some things set it off one time and not another but I guess certain brands of stuff have gluten in them and others dont... any info on how to go about getting tested for this would be helpful thanks


This discussion is related to Severe abdominal pain.
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The ‘standard’ way to look for celiac is via a blood test, which I’ll get to in a moment. The ‘gold standard’ (supposedly) is via endoscopy in which a biopsy of the small intestine is viewed for signs of celiac problems. Other ways of testing include genetic, as well as an antibody stool test, which I consider much more accurate than either the blood test or the biopsy in a number of cases. Many people with visible damage to the small intestine have had negative blood tests.

You may want to refer to www.celiac.com (testing and diagnosis section) for more info, as well as www.enterolab.com.

Blood tests for Celiac Disease - There are a total of 6 tests that can be run for Celiac disease.
(1) Anti-Gliadin (AGA) IgA
(2) Anti-Gliadin (AGA) IgG
(3) Anti-Tissue Transglutamise (tTg) IgA
(4) Total Serum IgA
(5) Anti-Tissue Transglutamise (tTg) IgG
(6) Endomesial Antiobody (EMA) IgA

AGA is the abbreviation for Anti-Gliadin antibody, tTg is for Tissue transglutimase and EMA for Endomesial antibody. The tests with IgA test for the IgA antibody in the system. The IgG tests test for IgG antibodies in the system. The most indicative tests (supposedly) of Celiac are the tTg-IgA (#3) and the EMA (#6).

What is often referred to as the “Celiac Disease Panel” consists of the first 4 tests - above. These are the “standard” tests that should always be run to test for Celiac disease. Number 4 - Total Serum IgA should definitely be included. This tells you if your body is able to produce IgA antibodies – it’s something that needs to be considered because some celiacs are ‘deficient’ in this parameter. If you can’t produce IgA antibodies, the IgA test results (#1, 3, and 6) will be very ‘problematic’ (probably negative) even if you have Celiac disease. Therefore, you also need to have the IgG numbers/tests run. #5 may be run only if Total Serum IgA indicates a deficiency and/or if the AGA IgG (#2) is the only one that is abnormally high (from what I understand).

EMA is suggested to be very sensitive for CD, but the interpretation of this test needs to be ‘read’ by someone experienced, and that can’t always be guaranteed. The tTg-IgA test is easier to interpret and is apparently less costly, so it’s become the ‘quick and dirty’ “standard.” Many docs will just run this and nothing else. If the results come back negative, you’re told ‘no celiac’ – and it leaves a lot of people suffering needlessly.  
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