Symptom Review
Dr. Farag evaluates your digestive history, food reactions, and related systemic symptoms to guide testing strategy.
CICA Intestinal & Celiac Assessment in Fort Myers, FL
Gut Barrier & Celiac Testing
Your CICA Intestinal & Celiac Assessment at a glance:
Test Type:Blood draw
Markers Tested:Gut & celiac
Results Time:1-2 weeks
Follow-Up:Included
When Your Gut Barrier Breaks Down
Beyond Basic GI Testing
You've tried elimination diets, probiotics, and digestive enzymes, but the bloating, cramping, and food sensitivities persist. Standard GI evaluations often focus on structural abnormalities or acute infections, missing the underlying dysfunction: a compromised intestinal barrier. When the tight junctions between your intestinal cells weaken, larger molecules pass through the gut wall into your bloodstream - triggering immune responses, systemic inflammation, nutrient malabsorption, and symptoms that extend far beyond the digestive tract, including joint pain, brain fog, skin issues, and chronic fatigue.
The CICA (Comprehensive Intestinal and Celiac Assessment) at RegalMed Clinic evaluates the integrity of your gut barrier alongside celiac-specific markers and intestinal inflammation indicators. Dr. Farag uses this multi-marker approach to determine whether you have intestinal hyperpermeability (leaky gut), celiac disease or gluten sensitivity, and active gut inflammation. With these precise results, she develops targeted treatment protocols addressing the specific mechanisms driving your symptoms - whether that's gut barrier repair, dietary modification, immune modulation, or a combination approach.
What Is a CICA Assessment?
Intestinal Permeability Analysis
The CICA (Comprehensive Intestinal and Celiac Assessment) is an advanced blood-based diagnostic panel that evaluates intestinal barrier integrity, celiac disease markers, and gut inflammation biomarkers in a single comprehensive test. It measures antibodies to zonulin (a protein that regulates intestinal tight junctions), anti-tissue transglutaminase (tTG-IgA and tTG-IgG for celiac screening), deamidated gliadin peptide antibodies, and actomyosin antibodies that indicate intestinal epithelial cell damage.
Unlike basic celiac screening that only checks tTG-IgA, the CICA panel provides a multi-dimensional view of gut health. It can detect non-celiac gluten sensitivity, identify intestinal hyperpermeability even in the absence of celiac disease, and quantify the degree of intestinal inflammation and barrier breakdown. This comprehensive approach helps Dr. Farag distinguish between celiac disease, gluten sensitivity, and other causes of intestinal permeability - each requiring different treatment strategies.
Treatment Timeline
Blood Draw
Single venipuncture, 10-15 minutes
Lab Processing
Antibody analysis over 1-2 weeks
Results Review
Comprehensive consultation with Dr. Farag
Retest Interval
3-6 months to monitor gut healing
Benefits of CICA Testing
Comprehensive Gut Insight
- 01
Multi-Marker Approach
Evaluates intestinal permeability, celiac markers, and gut inflammation simultaneously
- 02
Diagnostic Clarity
Distinguishes between celiac, gluten sensitivity, and non-gluten barrier dysfunction
- 03
Root Cause Detection
Identifies the mechanism behind chronic digestive symptoms and food reactions
- 04
Treatment Guidance
Results directly inform whether you need dietary changes, gut repair protocols, or both
- 05
Simple Collection
Single blood draw provides comprehensive assessment without invasive procedures
CICA vs Other Gut Tests
Compare Your Options
| Treatment | Mechanism | Time | Results | Duration | Downtime | Best For |
|---|---|---|---|---|---|---|
| CICA Assessment | Intestinal permeability and celiac antibody panel | 10-15 min draw | 1-2 weeks | Current gut barrier status | None | Leaky gut, celiac, and gluten sensitivity evaluation |
| Food Sensitivity Testing | IgG/IgA antibody response to 100+ foods | 10-15 min draw | 1-2 weeks | Current immune reactivity | None | Identifying specific food triggers causing inflammation |
| Histamine Intolerance Testing | DAO enzyme and histamine metabolism markers | 10-15 min draw | 1-2 weeks | Current enzyme status | None | Histamine-related reactions and DAO deficiency |
Who Should Get a CICA Assessment?
Candidacy Assessment
CICA intestinal and celiac assessment is especially valuable for patients with persistent digestive symptoms that haven't been fully explained by standard GI testing. It provides diagnostic clarity for a wide range of gut-related conditions.
Ideal Candidates for CICA Assessment
- Adults with chronic bloating, gas, abdominal pain, or irregular bowel habits
- Patients with multiple food sensitivities or reactions to foods they previously tolerated
- Individuals with suspected but unconfirmed celiac disease or gluten sensitivity
- Patients with autoimmune conditions where intestinal permeability may be a contributing factor
- Those with systemic symptoms (fatigue, brain fog, joint pain, skin issues) potentially linked to gut dysfunction
Who May Not Need This Test
- Patients with confirmed celiac disease already on a strict gluten-free diet (standard monitoring may suffice)
- Individuals with acute GI symptoms requiring urgent evaluation (endoscopy or imaging may be more appropriate)
- Those without digestive complaints or related systemic symptoms
Dr. Farag will evaluate your symptom history and previous test results during consultation to determine if CICA assessment is the right diagnostic step for your situation.
What Happens During Your Test
Blood Draw
A single venipuncture collects your blood sample for comprehensive intestinal permeability and celiac antibody analysis.
Lab Analysis
The lab measures zonulin, actomyosin, tTG, and deamidated gliadin antibodies over 1-2 weeks.
Results Review
Dr. Farag explains each marker, distinguishing between celiac, gluten sensitivity, and barrier dysfunction.
Treatment Plan
A targeted gut repair protocol is designed based on your specific findings - dietary changes, supplements, and follow-up testing.
Side Effects & Considerations
What to Know
The CICA assessment is a standard blood draw with minimal risk. All side effects are related to the venipuncture procedure itself.
Common Side Effects
- Minor bruising or soreness at the blood draw site lasting 1-2 days
- Brief lightheadedness during or immediately after the draw (uncommon)
Important Considerations
- If celiac disease is suspected, you should NOT be on a gluten-free diet before testing - gluten must be present in your diet for celiac antibodies to be detected accurately
- Patients already on a gluten-free diet for more than 2-4 weeks may have falsely low celiac markers; a gluten challenge may be recommended
- Immunosuppressive medications may affect antibody levels - inform Dr. Farag of all current medications
- IgA deficiency can cause false-negative results on tTG-IgA; the CICA panel includes IgG markers to account for this
There are no systemic risks from the test itself. Dr. Farag interprets all results in the context of your dietary history and medication use for accurate clinical conclusions.
CICA Assessment Cost in Fort Myers
Transparent Diagnostic Pricing
CICA intestinal and celiac assessment at RegalMed Clinic provides diagnostic precision that can end years of unexplained digestive symptoms and guide effective treatment from the start.
Pricing Overview
Comprehensive CICA panel testing typically ranges from $250-$450 depending on the specific markers included. This covers the blood draw, multi-marker laboratory analysis, and a detailed results review with Dr. Farag.
What's Included
- Initial consultation and digestive symptom assessment
- Blood draw and specimen processing
- Intestinal permeability markers (zonulin, actomyosin antibodies)
- Celiac disease panel (tTG-IgA, tTG-IgG, deamidated gliadin peptides)
- Follow-up consultation with gut health protocol
Insurance & Payment
Some components of the CICA panel (particularly celiac screening) may be covered by insurance with appropriate diagnostic codes. The intestinal permeability markers are typically classified as functional medicine testing. RegalMed Clinic accepts major credit cards and can provide documentation for HSA/FSA reimbursement. Contact our Fort Myers office at (239) 395-2434 for pricing and insurance verification.
Why Choose RegalMed Clinic
Fort Myers Gut Health Expert
Functional Expertise
Dr. Farag combines family medicine with advanced functional GI diagnostics
Integrated Analysis
CICA results correlated with food sensitivity and nutritional testing for complete picture
Targeted Protocols
Gut repair programs customized to your specific barrier dysfunction pattern
Progress Tracking
Retest intervals verify gut healing and guide protocol adjustments over time
Related Services
Advanced Diagnostic Testing
Regenerative Medicine
CICA Assessment FAQ
Answers to Your Questions
01 What is leaky gut and how does CICA test for it?
Leaky gut (intestinal hyperpermeability) occurs when the tight junctions between intestinal cells weaken, allowing larger molecules to pass into the bloodstream. The CICA panel detects this by measuring antibodies to zonulin (a protein that opens tight junctions) and actomyosin (released when intestinal cells are damaged), providing objective evidence of barrier dysfunction.
02 Do I need to be eating gluten before the test?
Yes, if celiac disease is being evaluated. You should be consuming gluten regularly for at least 2-4 weeks before testing for celiac antibodies to be detectable. If you've been gluten-free, Dr. Farag may recommend a supervised gluten challenge before ordering the panel.
03 How is this different from a standard celiac test?
Standard celiac screening typically checks only tTG-IgA. The CICA panel adds tTG-IgG (important for IgA-deficient patients), deamidated gliadin peptides (can detect gluten sensitivity), plus intestinal permeability markers that standard celiac tests completely ignore.
04 Can CICA testing replace an endoscopy?
CICA testing provides valuable antibody-based diagnostic data but does not replace endoscopy with biopsy, which remains the gold standard for confirming celiac disease. However, CICA results help Dr. Farag determine whether endoscopy referral is warranted and provide information about gut barrier function that endoscopy cannot assess.
05 How long does gut healing take after treatment?
Most patients see measurable improvement in intestinal permeability markers within 3-6 months of following a targeted gut repair protocol. Complete gut barrier restoration depends on the severity of dysfunction, adherence to dietary changes, and underlying contributing factors.
06 Will insurance cover this test?
Celiac screening components may be covered with appropriate diagnostic codes. Intestinal permeability markers are typically out-of-pocket as functional medicine testing. Contact Regal Med Clinic at (239) 395-2434 for current pricing and insurance verification assistance.
Location15750 New Hampshire Ct, STE D
Fort Myers, FL, 33908
Fort Myers, FL, 33908
Phone(239) 395-2434
Schedule Your CICA - Intestinal & Celiac Assessment Consultation
References
- PubMed (PMID: 22109896) - Zonulin as a biomarker for intestinal permeability: validation and clinical significance in patients with gut barrier dysfunction.
- PubMed (PMID: 16635908) - Intestinal permeability and its regulation by zonulin: diagnostic and therapeutic implications for autoimmune and inflammatory conditions.
- PubMed (PMID: 28239451) - Tissue transglutaminase antibodies in celiac disease: systematic review of diagnostic accuracy across IgA and IgG subtypes.
- PubMed (PMID: 25583468) - Non-celiac gluten sensitivity: clinical presentation, diagnosis, and emerging understanding of pathophysiology.
- PubMed (PMID: 29056514) - Intestinal barrier function in health and gastrointestinal disease: review of pathophysiology and clinical biomarkers.