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Celiac Center

Diagnosis

How is it diagnosed?

Celiac disease can be difficult to recognize because some of its symptoms are similar to those of other diseases. As a result, celiac disease has long been underdiagnosed or misdiagnosed as irritable bowel syndrome, chronic fatigue, inflammatory bowel disease, intestinal infections, etc. Because of increased awareness about celiac disease and availability of reliable blood tests, diagnosis rates are increasing. When celiac disease is suspected, diagnosis is made based on a blood test and a small intestine biopsy.

Blood TestBlood Tests: People with celiac disease have elevated level of certain antibodies in their blood. These antibodies are specific to celiac disease. Blood can be tested for TTG-antibodies (tissue transglutaminase) or EMA (endomyosium antibodies). There is no need to be fasting for these antibody tests. In our center we test for TTG-antibodies as part of our initial work up. If test results are negative but celiac disease is still suspected, additional blood tests may be needed.

Intestinal Biopsy: If blood tests and symptoms suggest celiac disease, a biopsy of the small intestine is performed to confirm the diagnosis. During the biopsy, tiny pieces of tissue are collected from the small intestine to check for damage. To obtain the tissue sample, an upper endoscopy (EGD) is performed.

What is the role of screening in celiac disease?

Celiac disease can run in families. First degree relatives (parents, brothers or sisters, and children) have a 1 in 22 chance of also having celiac disease. It is recommended that first degree relatives be screened. Screening is done with a blood test for the TTG antibody. If this is positive, then a biopsy is required. If it is negative, it should be repeated every three years thereafter. The blood test can be ordered by us or your PCP.

Learn more about Celiac Disease in our Health Information Library.

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