Mucosal inflammation of the small intestine, coupled with damage to intestinal villi, is a classic indication of celiac disease. Recently, doctors have begun to embrace the idea that some patients with positive celiac blood tests may have mucosal lesions that are too small to appear on routine histopathological analysis.

Among the main things doctors look for when they’re trying to make a classic diagnosis of celiac disease are small intestinal mucosal membrane villous atrophy and inflammation. However, the latest research indicates that these criteria are possibly too narrow, leading to a lack of diagnosis and treatment of people with celiac disease. If so, far more people than previously imagined may suffer from celiac disease and not even know it.

ActoGeniX is a recently formed Belgian company specializing in the development and use of genetically altered probiotic Lactococcus lactis bacteria designed to secrete and deliver therapeutic peptides and proteins to treat gastrointestinal disorders. Their product is called ActoBiotics™. Celiac disease is among the disorders ActoGeniX is currently investigating. Research has already shown efficacy in a celiac disease model where ActoBiotics™ continuously secrete small segments of gluten peptides to induce tolerance to gluten. Further research and trials are in the pipeline.

A greater awareness of celiac disease, coupled with better and more accurate tests for celiac disease have helped to bring about a situation where most people currently diagnosed with celiac disease show no symptoms at the time of their diagnosis. Currently, most people diagnosed with celiac disease do not show symptoms, but are diagnosed on the basis of referral for elevated risk factors.

This question, “how early can you diagnose celiac disease?” is a major concern for both parents and paediatricians.  This is because, like many diseases, celiac disease comes on slowly.  This means that it can take a long time to make the diagnosis.

A new confocal laser microscopic probe has been developed by Mauna Kea Technologies which works in conjunction with conventional endoscopes providing real-time video sequences of the intestinal mucosa magnified 500-1000 times greater than the conventional endoscopic view.

A recent study published in the August issue of American Journal of Gastroenterology suggest that villous atrophy in suspected cases of celiac disease can be reliably detected by video capsule enteroscopy (VCE).

A team of Dutch dentists recently conducted a study to determine if Dutch children with proven celiac disease exhibit corresponding defects in dental enamel and to gauge whether children without proven celiac disease, but showing celiac-associated gastro-intestinal complaints lack any such defects in their dental enamel.

Figures concerning the diagnostic accuracy of various serologic test and HLA-DQ typing for diagnosing celiac disease have largely come from case–control studies.

Celiac disease is one of the most common lifelong disorders in western countries. However, most cases in North America remain currently undiagnosed, mostly because they present unusual symptoms and because of the low number of doctors who have a sound awareness of celiac disease.