What investigations are needed to detect gluten sensitivity?
When gluten comes into contact with the intestinal lining of a person who is sensitive to it, changes occur which are detectable under a microscope. The characteristic change is flattening of the projections called villi , which resemble pile in a carpet though in a few people there may only be an alteration in the surface layer of cells. The most important test is to examine a tiny snip, known as a biopsy, from the surface of the small intestine. A flexible telescope (endoscope) is usually passed through the mouth into the stomach and upper intestine so that the lining can be inspected and a biopsy taken. This process takes only a few minutes and is often made easier and less uncomfortable by giving a mild sedative beforehand. Alternatively, a biopsy can be obtained by swallowing a special capsule on the end of a narrow tube. If the biopsy is abnormal, a second test may be advised after a period to check that the intestinal surface returns towards normal. When there is doubt about a p
