Gluten is a protein compound that is part of the gluten of cereals. With intolerance to this component, it is customary to talk about a disease such as celiac disease. According to statistics, the largest number of cases of detection of the disease recorded in the United States and EU countries. However, in the Russian Federation there are many people suffering from intolerance to the protein compound. If disturbing signs occur, consult a doctor. The following information is provided on how to determine gluten intolerance, tests that need to be done, and how to interpret their results.
Celiac disease: a developmental mechanism
Normally, the food that enters the body goes through several stages of cleavage. As a result, the nutrient components are absorbed by the intestinal mucosa, and the formed feces go outside. Under the influence of a provoking factor, this process is disrupted. The role of the latter is, as a rule, a genetic predisposition. If immediate relatives suffer from celiac disease, then the likelihood of developing the disease is about 90%.
When partially digested food containing gluten enters the small intestine, the development of the inflammatory process starts. This is due to a lack of enzymes that break down L-gliadin (a substance that is part of the protein compound). A logical result is the production of toxins that have a negative effect on the intestinal mucosa. The villi covering it atrophy. In addition, the absorption of nutrients is disrupted. At this stage, the patient begins to manifest severe symptoms.
Indications
Gluten intolerance analysis is prescribed when, in the course of other studies, diseases with similar symptoms were not detected. This is due to the fact that celiac disease masquerades as many pathologies, the presence of which must be confirmed or excluded.
A gluten intolerance test is also indicated if the patient has the following symptoms and conditions:
- pain in the abdomen;
- diarrhea
- signs of anemia;
- a sharp decrease in body weight for no apparent reason;
- multiple caries;
- hemorrhages in the limbs and / or abdomen;
- infertility
- thirst, which is almost impossible to quench (in some cases we are talking about polydipsia);
- pain in the muscles and joints;
- stomatitis;
- persistent dermatitis;
- glossitis;
- constant mood swings, unexplained anxiety;
- dizziness
- excessive sweating;
- constant feeling of tiredness;
- feces of black color against the background of intestinal bleeding.
In children, celiac disease can be suspected by their appearance. These babies have an unnaturally swollen stomach. They are irritable, tearful and often refuse food. Another symptom is loose foamy stools. Fecal matter has a fetid odor and contains a lot of fatty inclusions.
When these symptoms appear, it is necessary to show the child to the doctor. The specialist will prescribe an examination, which will necessarily include an analysis of intolerance to gluten, lactose and casein (high sensitivity of the body to all these substances is similar in clinical manifestations).
Immunological studies
In the process of their implementation, the presence of antibodies is determined, the formation of which is a response of the body to the entry of products containing a protein compound into it.
A doctor must provide information about which test to pass for gluten intolerance. Currently, there are two immunological studies with which it is possible to confirm or exclude the presence of celiac disease.
These include:
- Analysis for the detection of antibodies to tissue transglutaminase. This is an enzyme that is present in many body tissues. In addition, it is tissue transglutaminase that is directly involved in the formation of the immune response after products containing a protein compound enter the esophagus. This is a specific and highly accurate analysis of intolerance to gluten, casein and lactase, the essence of which is the detection of IgA antibodies. If available, their concentration is determined. A small amount of antibodies indicates an early stage of the development of the disease, a significant one indicates the progression of pathology and atrophy of the mucosa. For the final confirmation of the diagnosis, instrumental diagnostic methods are prescribed. This is usually an intestinal biopsy.
- Analysis for the detection of IgG and IgA to endomysium. This is a connective tissue that has a loose surface. At the same time, it is not its presence that is of clinical importance (each person has it), but the reaction of the body. According to clinical studies, the identification of a large number of antibodies (more than 40) to endomysium almost always indicates gluten intolerance. A result of less than 40 requires a comprehensive examination. The final diagnosis in this case has not yet been made.
These tests for gluten intolerance imply a study of the body's reactions in response to the intake of a protein compound in the body.
Genetic research
It is carried out by real-time PCR method. The essence of genetic analysis for gluten intolerance is to determine HLA. This is a human leukocyte antigen that is located on the surface of cells. There are more than one hundred thousand, but only two are associated with the development of gluten intolerance: HLA-DQ2 and HLA-DQ8.
They are directly involved in the final immune response. Interpreting the results is quite simple. The presence of these antigens in the blood (in absolutely any concentration) is the reason for the further examination. In their absence, the diagnosis of celiac disease is not confirmed.
Training
In order for the results of laboratory tests to be as reliable as possible, certain rules must be followed for some time.
Preparation for the delivery of biomaterial:
- Blood sampling is carried out on an empty stomach. The last meal should take place no later than 8 hours before the time prescribed by the doctor. If the patient observes a gluten-free diet, it is necessary to refuse it in 1-2 days.
- It is forbidden to drink tea, coffee and juice immediately before giving blood. It is allowed to take several sips of clean still water.
- The attending physician must be informed in advance about all medications taken. A specialist can temporarily stop the use of certain drugs. If this is not possible for health reasons, the doctor will take this fact into account when deciphering the results.
In addition, in 2 days it is recommended to avoid getting into stressful situations. It is proved that psycho-emotional instability can lead to false results.
Biomaterial sampling algorithm
Gluten intolerance testing involves examining fluid connective tissue. The biological material is venous blood. Its fence is carried out according to the standard scheme: the doctor imposes a tourniquet above the elbow and, when the vessel is filled, inserts a needle into it. As soon as the syringe is filled with blood, the medical device is removed from the vein. If the vessel is inaccessible, use another located on the wrist.
Other methods
With positive results of laboratory tests, one of the following diagnostic methods is prescribed:
- Small intestine biopsy. The procedure resembles fibrogastroduodenoscopy. Through the oral cavity, a rubber tube is introduced into the body, equipped with a miniature camera and a tool for collecting biomaterial. During the procedure, the doctor gets the opportunity not only to cut off a small piece of the mucous membrane, but also to evaluate its external condition. The degree of atrophy allows you to judge the stage of the disease.
- General blood analysis. A sign of celiac disease is anemia.
- Biochemical blood test. Clinically significant are indicators of calcium, potassium, "bad" cholesterol, albumin, alkaline phosphatase.
- Coagulogram. With celiac disease, the study will reveal an increase in the duration of the prothrombosis process.
- Coprogram. A sign of illness is an increased fat content.
- X-ray examination, CT and MRI. They reveal intestinal expansion, lymphadenopathy, as well as assess the condition of the mucosa.
It so happens that the test results contradict each other. In this case, an additional examination is carried out.
Assistant Diagnostic Methods
If there are controversial results, the doctor chooses which test for gluten intolerance the patient needs to pass. For the final confirmation or exclusion of the diagnosis, the following studies may be prescribed:
- liver tests;
- colonoscopy;
- Ultrasound of the thyroid gland and abdominal organs;
- enteroclysis;
- bone densitometry.
Without fail, the doctor directs the patient to FGDS.
Forecast
With timely access to a doctor, in most cases it is favorable. The main method of treating an ailment is to adjust the diet. All cereals should be excluded from the menu. As a rule, against the background of a gluten-free diet, the symptoms completely disappear after 3-6 months. It is important to understand that when confirming celiac disease, nutritional nutrition must be followed throughout life.
For children, a doctor's intervention is required immediately after the onset of warning signs. In children, the ailment is a threat not only to health but also to life, so a blood test for gluten intolerance must be done as soon as possible.
Finally
Gluten is a protein compound that is present in cereal gluten. Some people have intolerance to it. In this case, it is customary to talk about celiac disease. This disease is mainly hereditary. Medications for the disease are powerless. Patients only need to follow a gluten-free diet and monitor for the presence of hidden gluten in various products, because manufacturers often add cereals even to ketchup.