Diagnosing Celiac Disease

There are two steps to finding out if you have celiac disease: screening and diagnosis. You should always consult with a physician experienced with celiac disease to ensure proper diagnosis.

Why get screened?

Celiac disease is a lifelong autoimmune disorder that affects multiple parts of your body which can lead to other serious illnesses whether or not you are on a gluten-free diet.  Once diagnosed, follow up with your physician is necessary to monitor nutritional deficiencies and your compliance with a gluten-free diet, as well as assess for associated conditions.  Also, your children, siblings and parents are at risk.  If you have celiac disease, there is a 1 in 10 chance that they do too.

 Who should get screened?

  1. Children older than 3 and adults experiencing symptoms of celiac disease
  2. First-degree relatives of people with celiac disease (parent, child, sibling)
  3. Any individual with a related autoimmune disorder

Screening

There are several serologic (blood) tests available that screen for celiac disease antibodies, but the most commonly used is called a tTG-IgA test. If test results suggest celiac disease, your physician will recommend a biopsy of your small intestine to confirm the diagnosis.

IMPORTANT:  You must NOT be on a gluten-free diet.  If you are on a gluten-free diet, CDF’s medical experts recommend a “Gluten Challenge” – daily consumption of gluten equivalent to at least 4 slices of bread for one to three months followed by an endoscopic biopsy with no serology testing.


Diagnosis

A diagnosis can be reached by undergoing an endoscopic biopsy. This procedure is performed by a gastroenterologist and is an outpatient procedure. A biopsy is taken of the small intestine, which is then analyzed to see if there is any damage consistent with celiac disease. The diagnosis may be confirmed when improvement is seen while on a gluten-free diet.


Gluten Sensitivity

Not all people who react negatively to gluten actually have celiac disease. The symptoms of gluten sensitivity are similar to those of celiac disease. People who are gluten sensitive experience symptoms in response to eating gluten, but will not have intestinal damage and will test negative for celiac disease antibodies.