In her recent article in the University of Chicago’s Celiac Disease Center newsletter, “Impact,” Dr. Carol Semrad seeks to clarify the important steps needed to accurately diagnose celiac disease.

Traditionally, celiac disease has been diagnosed by duodenal (small bowel) biopsy, however, there are a number of different ailments and conditions that can lead to small bowel inflammation, of which celiac disease is only one. Other possible causes are acid injury, bacterial overgrowth, Crohn’s Disease, and tropical sprue. Certain medications can also cause inflammation, especially in older adults, and it is critical that biopsies be reviewed by an expert gastroenterological pathologist to make sure that all possible causes are considered and assessed. Research shows that when two biopsies are obtained, diagnosis is confirmed in 90% of cases; that number rises to 95-100% with three to four biopsies.

The best possible route for diagnosing celiac disease includes both intestinal biopsy and testing for celiac disease antibodies. While antibody testing is less invasive, clinical studies have shown that patients who have also had celiac disease confirmed through biopsy are likely to take both diagnosis and treatment more seriously.

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