The children who have had CD for several months will have bloating of the stomach and a loss of muscle mass. If not treated, malabsorption will continue to cause undernourishment and all the signs and symptoms that accompany it. The main way of diagnosing CD has always been through biopsy of the small bowel. Under a microscope, the small bowel will show characteristic damage to the lining. One way this is done by having the child swallow a capsule attached to a string, which is used to retrieve the capsule after a period of time.
Many doctors prefer to do a biopsy under direct endoscopy, however.
So the best thing would be to have an easy blood test that can detect the children who need the diagnostic biopsy. When the AGA and EMA tests are combined, this produces an effective screen to determine who should receive the biopsy. TG is an intracellular enzyme that binds gliadin and starts to process it. It is currently thought that the processed gliadin is what starts the autoimmune sequence in celiac disease. Diagnosis of this infection is done by special tests on the stools.