Celiac

Celiac

Stool Test for Celiac Disease

Celiac disease (coeliac disease, coeliac sprue or gluten allergy) is an autoimmune disorder of the small bowel that occurs in genetically predisposed individuals in all age groups after early infancy. Coeliac disease is caused by an abnormal reaction to gliadin, a gluten protein found in wheat, spelt, barley, rye and to a lesser amount in oats.

The breakdown of gluten is induced by the enzyme tissue transglutaminase, which binds to this substance. In some people who have a genetic disposition these gluten-transglutaminase complexes are recognised as foreign by the immune system. The immune system reacts by producing auto-immune antibodies against gluten, transglutaminase and these complexes as well as producing immune regulatory substances. Due to the antibodies against the transglutaminase this enzyme is blocked and cannot fulfil its natural functions, one of which is activating tissue growth factors. This leads to the atrophy of the gut mucosa. At the same time immune modulators like interleukines and cytokines are produced which fuel a constant inflammatory process in the mucosa. This exacerbates the damaging effect. Affected people suffer from malabsorption of nutrients leading to vitamin and mineral deficiencies, anaemia, osteoporosis and many other problems.The only effective treatment is a diet, lifelong in principle, from which gluten is absent. This usually results in improvement, or even disappearance, of the damage to the lining of the bowel. However, the damage will recur if gluten is re-introduced into the diet.

The condition is often diagnosed in childhood after weaning when cereals are introduced into the diet, although it can be diagnosed at any age. Symptoms may include diarrhoea, failure to thrive (in children), fatigue or even infertility but these may be absent. The symptoms can be subtle and the person may just feel unwell for no apparent reason for some time before the diagnosis is made.
The condition affects approximately 1 in 200 people in the European population, though it is significantly under diagnosed.

HOW DOES THE STOOL TEST WORK?
It is important to diagnose the coeliac disease in early stages to prevent long term damage. Usually a medical doctor will order a blood test and an endoscopy with a biopsy of the small bowel, an invasive and uncomfortable procedure which requires going into hospital. The Dr. Hauss Laboratory uses a method which was only developed in 1997 (Dietrich et al. 10097). From a simple stool sample this test can detect specific intestinal sIgAs against the enzyme tissue transglutaminase. This is more specific than the blood test for anti-gliadin antibodies, uninvasive, simple and cost effective. Only in case of a positive result a biopsy and an additional blood test is recommended to verify the diagnosis.

THE PATIENT/PRACTITIONER BENEFIT

  • simple test to exclude coeliac disease with unclear and persistent symptoms
  • uninvasive procedure
  • cost effective
  • easy monitoring of therapy success

CLINICAL APPLICATIONS
The symptoms of coeliac disease can be very different. However, this list can give a guideline.

  • Typical symptoms in adults

Chronic diarrhoea, tiredness, Weight loss, bloating, lack of iron or folic acid, menstruation irregularities, nausea and vomiting, abdominal bloating, cramps and pain, IBS symptoms.

  • Typical symptoms in children

Chronic diarrhoea with bulky, nasty smelling and fatty stool, Constipation in 15% of all cases, dystrophia with lack of subcutaneous fat, bloated abdomen, symptoms of rickets through lack of vitamin D, infection susceptibility, reduced growth, anorexia and paleness, muscle wastage, lethargic and weepy behavior.

  • Atypical symptoms in children and adults

Anaemia (iron therapy resistant), restricted growth, dermatitis mostly on elbows and knees (called dermatitis herpetiformis), bone disease, high amino-transferase (GOT, GPT), psychiatric problems, alopecia, mouth ulcers etc.(Holmes 1996; Barr and Graham 1998; Branski and Troncone 1998, modified)

Coeliac in diabetes mellitus patients
A high prevalence of coeliac disease is found in patients with diabetes (up to 20% in children, up to 5.6% in adults). Because the clinical symptoms are usually atypical we recommend screening all diabetes patients with a coealic stool test.

Infertility and abortion tendency
Different studies have found a connection between coeliac disease and a tendency to have spontaneous abortions. In a study with 2 control groups the abortion rate of women with coeliac disease was reduced significantly under a gluten free diet. (Ciacci et al. 1996).

Sample requirement for the BTS stool test
One single stool sample.
Important!!! The patient has to consume gluten for at least one week before the test. Otherwise no antibodies will be found.


Comments

Celiac — 4 Comments

  1. Which test do I need to purchase for the test for ceolic disease. My mum had the condition and now I suffer from abdominal upsets

    • Dear Elaine, I have only just seen your comment. I am very sorry that I missed it.
      No Idea why my mail did not show it.
      Anyway, on our website we do not offer a test for celiac, but our laboratory does a stool test which costs 53 GBPs.
      Should you still be interested, please write me an email to ute@candidatest.co.uk
      Best regards, Ute

  2. Dear Julie,
    Our laboratory always advises us that the patient should have had gluten for at least one week, but better for two weeks prior to the test.
    And as you might have seen from our website, this test is a stool test which is much gentler on a child than a blood test.
    It is not likely to get false results because the substance which is tested for is evenly distributed in the stool.

  3. Please advise if the coeliac test will work if a child has not been eating gluten for more than a year?
    Most tests say you have to consume gluten for a minimum of SIX weeks before a coeliac blood test TTa will work.
    Will your test work if you only have to eat gluten for one week?
    Do you ever get false results?

Leave a Reply

Your email address will not be published. Required fields are marked *