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You should see your doctor if you think you might have celiac disease. Based on your symptoms and risk factors for the disease, he or she will determine if you need lab tests. Some people will need a biopsy of their upper intestine. If you are already on a gluten-free (wheat-free) diet, you may be paced on a gluten-rich diet and need additional tests.
Diagnosing celiac disease is not as clear cut as you might think because it has nonspecific symptoms such as fatigue and abdominal bloating.
The first caveat is that you must eat wheat (gluten) for the whole month before you are tested to get the most accurate evaluation. Blood tests are performed that check your antibodies, including the most sensitive test (meaning it will miss the fewest cases, but may have some false positives) -- the anti-tTG (anti-tissue transglutaminase antibody) test.
The doctor must also test your IgA levels (immunoglobulin A) because if you are not making adequate IgA, you could test negative for celiac disease even though you have it. Additional blood tests include anti-endomysial antibody (EMA-IgA) and anti-deaminated gliadin peptide (DGP – IgA and IgG).
Ultimately, the diagnosis will need to be confirmed not only with a blood test, but with a small bowel biopsy which is done through endoscopy. The biopsy will look directly at the lining of the gut and determine what level of damage exists.
Alternatively, you can choose to follow a strict gluten-free diet, and if your symptoms resolve, it is likely you have celiac disease (or at least gluten-intolerance). This is obviously less specific and accurate, but is certainly a good starting place.
This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.