Celiac Disease - Diagnosis

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How is celiac disease diagnosed?

The diagnosis of celiac disease is often delayed and it may take several months or years for the patient and the health care professional to think of it as the cause of many non-specific symptoms. History and physical examination may give direction as to the diagnosis, but commonly it take many visits with the patient complaining of recurrent abdominal pain, non-specific joint aches, or demonstrating chronic anemia that does not respond to iron treatment, to raise the suspicion that celiac disease is a possibility.

When the diagnosis is suspected, there is a two-step screening process to make the diagnosis:

  1. Blood test for immunoglobulin A anti-tissue transglutaminase antibody (IgA TTG). Testing for antiendomysial antibody may also be considered.
  2. If the screening blood test is positive, then endoscopy and biopsy of the lining of the duodenum (the first part of the small intestine) is recommended. Usually performed under sedation, a fiberoptic tube is passed through the mouth, through the esophagus and stomach into the duodenum and a small bit of tissue is taken to be examined under a microscope.

It is important that the patient eats a regular diet for many weeks before the testing procedures. If the patient has already started a gluten free diet, it may cause the tests to be falsely negative.

Once the diagnosis is made, screening for osteoporosis may be appropriate.

Since it is often familial, once one person in the family is diagnosed with celiac disease, it is reasonable to have other close family members screened.

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See what others are saying

Comment from: boyd1964, 45-54 Male (Patient) Published: December 11

It took two years and many doctors before one finally stumbled on celiac in 2001. Symptoms were sore joints, diarrhea, fatigue, weight loss, memory problems, depression, acid reflux. His first response was heavy metal poisoning, but then he remember he'd had his wife tested, and so tested me. I'm now in refractory phase with lymph problems and chronic fatigue.

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Comment from: Shannon, 35-44 Female (Patient) Published: December 11

I was experiencing hair loss. I have long hair and doctors initially thought it was due to thyroid condition that I did have...but turned out to reverse itself once I started the gluten free diet. I was diagnosed with an endoscopy for Celiac Disease.

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