Enterolab: Can the tests identify gluten intolerance?

Enterolab , a laboratory located in Dallas, Texas, tests for gluten intolerance (also known as gluten sensitivity) by looking for antibodies in your stool .

Although the tests offered by Enterolab have never been validated by outside laboratories or through other studies, many people who have used the tests claim that they accurately identify gluten intolerance.

Enterolab offers its services directly to consumers. Those who were unable to convince their doctors to prescribe the tests for celiac disease (or who had negative test results), can order the tests directly from Enterolab without having to go through a doctor to obtain a prescription.

Enterolab’s technology looks for gluten-related antibodies in your stool, not your blood.

Gluten sensitivity tests offered by Enterolab look for antibodies to gluten in the stool (fecal anti-gliadin IgA antibodies) and antibodies to the tissue enzyme transglutaminase, antibodies produced by the body when gluten is ingested (fecal anti-gliadin antibodies). -transglutaminase IgA). The tests are patented by Enterolab and only available there.

The American gastroenterologist, Dr. Kenneth Fine, medical director of the laboratory and former attending physician at Baylor University Medical Center, claims to have developed tests with the ability to more sensitively detect the damage caused by gluten before it becomes too prevalent in the body. His theory is that antibodies are present in the gut because that is where they are made and end up in the stool long before they appear in the bloodstream.

“To this day, I’m not sure how many people even know that it wasn’t me who came up with the idea, but rather this group of researchers led by the late Dr Anne Ferguson, who was a pioneer in evaluation of intestinal contents as a viable and more sensitive source of screening material for early immune system reactions to gluten. What we did in our research was to refine and simplify the method, to collect and measure these gut antibodies before they could be detected in the blood. That is, instead of washing out the entire intestine to extract the antibodies, we allow them to be excreted naturally in the stool (residue),” Dr. Fine reveals.

According to him, the fecal test is able to detect gluten sensitivity before it has progressed to the point of destroying the intestinal lining. “Because the antibodies produced by gluten sensitivity are primarily secreted in the intestine rather than the blood, there are more positive tests with the fecal test than with the blood test. In order for the antibodies to be produced in sufficient quantities to infiltrate the blood, the immune reaction must have been present for a long period of time and/or the process must be very advanced,” he says on his website. .

Enterolab also offers another advantage over blood tests used to screen for celiac disease: you don’t need to eat gluten for the test to be accurate. According to Dr. Fine, antibodies continue to be produced in decreasing amounts in the gut for several months after you stop eating gluten and furthermore, even small amounts of gluten in your diet can lead to a positive result if you are gluten sensitive.

A study carried out at the University Hospital of Tampere in Finland effectively demonstrates the presence of deposits of anti-transglutaminase antibodies in the intestinal wall, whereas these same antibodies are absent in the blood of gluten-intolerant patients. In another study still looking at the deposits of anti-transglutaminase antibodies in the intestinal wall, the same Finnish researchers also confirm the decreasing amount of antibodies produced in the intestine after abandoning gluten.

Several tests offered to detect gluten intolerance.

Enterolab offers four different tests to detect gluten sensitivity and gluten reactions in the body:

  • Gluten sensitivity stool test : This test looks for the presence of fecal anti-gliadin IgA antibodies, indicating an immune system reaction to gluten in the diet, Dr. Fine says.
  • Faecal tissue transglutaminase stool test : This test looks for the presence of faecal anti-transglutaminase IgA antibodies, indicating a reaction of the immune system against the enzyme tissue transglutaminase, a reaction that occurs when gluten is ingested by genetically predisposed people and that causes an inflammatory reaction that can destroy the intestinal lining or other tissues in the body, says Dr. Fine.
  • Quantitative fecal fat microscopy : This test measures the amount of fat present in the stool; large amounts of fat in the stool indicate a problem with malabsorption of nutrients and other fats meaning there is intestinal damage, according to Dr. Fine.
  • Gene test for genes linked to celiac disease and gluten intolerance : This test looks for the presence of one or more genes linked to celiac disease and gluten intolerance. gluten intolerance and other autoimmune syndromes.

Enterolab also offers faecal tests to screen for other sensitivities such as sensitivity to soy, casein, chicken eggs, yeast, etc… as well as a faecal test to detect chronic or acute colitis.

Enterolab tests are not covered by insurance

Customers pay for the tests they choose. Each of the tests can be purchased individually, for example the faecal test for gluten sensitivity costs US$99. It is possible to benefit from a certain discount and purchase the set of tests grouping together all the faecal tests described previously concerning gluten for 269 $US.

To order the tests, you visit the Enterolab website and pay for the chosen tests. Enterolab then sends a sample kit that you must return by air transport (frozen samples must reach their destination quickly) at your expense to the laboratory. The analysis usually takes a few weeks.

Because Enterolab offers its services directly to the consumer, most insurance companies do not reimburse the tests, but the costs may be eligible for a tax deduction. Furthermore, because Dr. Fine’s testing methods have not been accepted by most researchers (and he has yet to publish the results of his research in a mainstream medical journal), most physicians do not do not accept Enterolab faecal tests as a means of diagnosing gluten intolerance.

Enterolab’s tests cannot diagnose celiac disease; for this you usually need to have positive serological antibody tests and an endoscopy showing damage to your intestines.

Are Enterolab’s tests able to accurately identify gluten intolerance?

It is true that many people (60%) receive positive results from their Enterolab tests, indicating gluten intolerance. However, these people would not have taken these steps if they had not already suspected they had a gluten problem, so a high rate of positive results was expected and understandable. However, many people also report receiving negative results.

Few doctors accept positive Enterolab test results as proof of anything (but there are exceptions such as the gastroenterologist, Colorado- based Dr. Scott Lewey , himself diagnosed with gluten sensitivity by Enterolab and married to a celiac who is also a doctor), and no doctor would accept Enterolab tests to diagnose celiac disease (to be fair, Dr. Fine does not claim to diagnose celiac disease – only gluten sensitivity).

However, you don’t need a doctor’s permission to eat gluten-free. Many people turn to Enterolab testing after they’ve gotten a poor listen from their doctor about their symptoms, or received negative test results for celiac disease as they continue to suffer by consuming gluten.

Although there is as yet no published research proving the validity of Enterolab’s faecal tests, the existence of gluten sensitivity, brought to light by Dr. Fine at the beginning of this millennium on the basis of own research, was officially confirmed by a study by Dr. Fasano of the University of Maryland released in the spring of 2011. This further study confirmed another important revelation made earlier by Dr. Fine regarding the genetics of gluten intolerance, namely that other genes are also involved in the process of gluten sensitivity in addition to the two main genes predisposing to celiac disease.