New research suggests that those with positive celiac blood test should adopt gluten-free diet, even if biopsy is normal.
Individuals with biopsy-confirmed celiac disease are prescribed a 100% gluten-free diet, but treatment protocols are less clear for those with “potential” celiac disease, defined as having a positive celiac blood test but no evidence of intestinal damage. While these patients are typically given the option to continue ingesting gluten until a biopsy confirms celiac disease, new research indicates that they may benefit by going gluten-free before damage occurs.
Titled “Are patients with potential celiac disease really potential? The answer of metabonomics,” the new study examined 141 individuals, divided into those with overt celiac disease, those with potential celiac disease and a control group. Using a non-invasive approach, researchers analyzed the metabonic profile of all subjects and found that individuals with celiac disease had a “distinct metabonic signature,” according to the researchers. Researchers defined the metabonic profiles using urine and serum samples. Most of the altered metabolites defined in the overt celiac disease group were also found in subjects with potential celiac disease, suggesting that cases of potential celiac disease would likely progress toward overt celiac disease, confirmed by the presence of villous atrophy.
According to the researchers, these findings indicate that metabonic changes may precede villous atrophy in celiac disease sufferers. Therefore, those with potential celiac disease may be better served by adopting a gluten-free diet early on, rather than waiting for intestinal damage to occur.