Did you know that the prevalence of Coeliac disease is increasing? Here’s why….
- Early introduction of gluten, before 4 months of age (teething rusks for instance)
- Changes in gluten content of wheat varieties - Modern wheat varieties have higher gluten content.
- Changes in growing techniques/fertilisers applied - the more nitrogen applied to the wheat crop the greater the gluten content.
- Changes in food preparation techniques - Slower sourdough fermentation processes have now been converted to quick yeast breads to keep up with demand, which have very short periods of fermentation. Gliadin is broken down by microbes in the slower fermentation process, meaning that bread today contains way more gluten than it used to.
- Greater level of gluten consumption in the first 2 years of life.
- Increasing use of glyphosate - causing intestinal permeability and immune reactivity.
- We now have research to confirm that antibiotic use is associated with increased risk of Coeliac disease.
- Proton Pump Inhibitor use (Lebwohl et al, 2014)
- Medication use in the first 6 months of life and subsequent development of Coeliac disease (Boechler et al, 2023).
Read on if you want to know how to test for Coeliac disease, and more importantly how to prepare for a coeliac disease test, as this can significantly interfere with the result.
Coeliac disease testing and diagnosis:
There are a few different tests that you can order for coeliac disease diagnosis:
Genetic testing:
- HLA-DQ2 (95% of CD patients) carried by 30-40% of the general population
- HLA-DQ8 (most of the remaining 5%)
Antibody testing:
- Anti-tTG antibodies (tTG)
- Anti-endomysium antibodies (EmA) (less often use due to increased cost)
- Deamidated gliadin peptide (DGP) antibodies - often called “anti-gliadin” AB on Australian tests.
Gold standard diagnosis:
- Representative mucosal changes on biopsy obtained via gastroscopy.
Preparing for a coeliac disease test:
You must continue to consume a gluten rich diet prior to the test.
Technically you are supposed to complete a gluten challenge before the antibody screen which involves consuming the equivalent of 4 pieces of bread daily for a 6 week period. You can read more information on this here https://coeliac.org.au/health-professionals/gluten-challenge/
On another note – Lots of my clients believe that they are Coeliac or gluten intolerant, when in fact they have SIBO, where they’re reacting to fructans (found in high amounts in wheat products).
If you believe that you are reacting to gluten, yet you have obtained a negative test result, then make sure to rule out wheat allergy and non-coeliac gluten sensitivity.
All of the above tests are regularly screened for in my clinic, so feel free to reach out for an appointment and we’ll get the investigating underway.