Definition
Gluten intolerance is a disease with many different names: Celiac disease is the most common name in the medical field. But the disease can also be called native sprue or gluten-sensitive enteropathy.
Causes
Diagnostics
First of all, the anamnesis plays an important role on the way to finding a diagnosis. The attending physician will ask which symptoms are present, when they occur, which foods cause the symptoms to occur, whether there are similar symptoms in the relatives, whether there has been weight loss and how long the symptoms have existed. This is followed by a physical examination.
Among other things, the weight is checked here. If coeliac disease is suspected, blood tests can be carried out first. If there is a gluten intolerance, certain antibodies can be detected.
If this is done, however, it is not enough to make a reliable diagnosis. A gastroscopy must also be performed. This involves inserting a tube (gastroscope) through the throat and oesophagus into the stomach and up to the small intestine after anaesthesia of the throat or during a short anaesthetic.
Several samples (biopsies) must be taken from the small intestine. These are examined under the microscope by a pathologist. Here it can be assessed whether the atrophy of the villi, which is typical for gluten intolerance, occurs, i.e. a loss of certain surface characteristics of the mucous membrane of the small intestine.
It can also be assessed whether and how many inflammatory cells are present in the intestinal mucosa. The diagnosis can only be confirmed by such an examination of the mucous membrane samples. Specific tests that laypersons can perform to find out whether they suffer from gluten intolerance have also been available for some time.
First of all, if a gluten intolerance is suspected, an attempt can be made to switch to a completely gluten-free diet for a few weeks. If this results in a significant reduction in symptoms, the diagnosis is likely. The doctor treating the patient should then be consulted for final confirmation.
There are other tests, such as the D-xylose test, which attempt to measure how restricted the absorption of certain nutrients is in the small intestine. However, they are not sufficient for making a diagnosis. For this purpose it is absolutely necessary to take a sample from the small intestine.
For some time now, blood tests that can detect certain antibodies have been available to the layperson. The test is similar to the blood test carried out by a doctor. However, a negative result does not reliably exclude the presence of celiac disease.
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