Gluten Sensitivity Testing

One of the difficulties with going to a gastroenterologist is that some do not recognize non-celiac gluten sensitivity as a condition. Because of this they may only test for tTGA. These doctors believe you either have celiac disease or you don’t have a problem with gluten. The problem with the tTGA test is that it is very good at finding people with celiac disease, but most people who are gluten intolerant will test negative for tTGA. A study in 2003 showed that people who were gluten sensitive that had a “normal biopsy” where shown to have submicroscopic damage to the microvilli upon closer examination.1 Normal biopsies use a light microscope that magnify the sample by 400x where the microvilli are still not visible. To view the microvilli, a scanning electron microscope or transmission electron microscope is needed to be able to magnify to approximately 4000x. A medical pathologist would not see any abnormalities if the microvilli were damaged and the villi were intact.

There are currently no medications or surgeries that can reduce symptoms for those with gluten intolerance. The only treatment for celiac disease or non-celiac gluten sensitivity is avoidance of gluten in the diet. The reduction in the severity of symptoms after the elimination of gluten from the diet is also a method of confirming that a person is gluten intolerant. For those with a positive test for AGA, confirming with a gluten free diet is necessary.

One side effect of the gluten-free diet is developing an increased sensitivity to gluten. In many gluten sensitive individuals, the reaction to gluten is more severe the longer they have been gluten-free. People can develop symptoms when preparation or cooking areas have not been properly cleaned.

1. Sbarbati A, Valletta E, Bertini M, Cipolli M, Morroni M, Pinelli L, Tatò L.“Gluten sensitivity and ‘normal’ histology: is the intestinal mucosa really normal?” Dig Liver Dis. 2003 Nov;35(11):768-73.