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Tests and diagnosis
By Mayo Clinic staffCeliac disease may be much more common in the United States than previously believed. Part of the reason for the previous underdiagnosis of celiac disease may be because the disorder resembles several other conditions that can cause malabsorption. In addition, specific blood tests now allow for diagnosis of people with celiac disease who have very mild signs and symptoms or none at all.
People with celiac disease carry higher than normal levels of certain antibodies (anti-gliadin, anti-endomysium and anti-tissue transglutaminase). Antibodies are specialized proteins that are part of your immune system and work to eliminate foreign substances in your body. In people with celiac disease, their immune systems may be recognizing gluten as a foreign substance and producing elevated levels of antibodies to get rid of it.
A blood test can now detect high levels of these antibodies and is used to initially detect people who are most likely to have the disease and who may need further testing. To confirm the diagnosis, your doctor may need to microscopically examine a small portion of intestinal tissue to check for damage to the villi. To do this, your doctor inserts a thin, flexible tube (endoscope) through your mouth, esophagus and stomach into your small intestine and takes a sample of intestinal tissue.
A trial of a gluten-free diet also can confirm a diagnosis, but it's important that you not start such a diet before seeking a medical evaluation. Doing so may change the results of blood tests and biopsies so that they appear to be normal.
- Kelly CP. Patient information: Celiac disease. http://www.uptodate.com/home/index.html. Accessed Sept. 17, 2008.
- Celiac disease. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/. Accessed Sept. 25, 2008.
- Schupann D, et al. Pathogenesis, epidemiology, and clinical manifestations of celiac disease in adults. http://www.uptodate.com/home/index.html. Accessed Sept. 17, 2008.
- Hill ID. Management of celiac disease in children. http://www.uptodate.com/home/index.html. Accessed Sept. 17, 2008.
- Ciclitira PJ. Management of celiac disease in adults. http://www.uptodate.com/home/index.html. Accessed Sept. 17, 2008.
- Nelson DA. Gluten-sensitive enteropathy (celiac disease): More common than you think. American Family Physician. 2002;66(12):2259-2266.
- Picco MF [expert opinion]. Mayo Clinic, Jacksonville, Fla. Oct. 9, 2008.
