Diagnosis

To confirm the diagnosis of celiac disease, doctors rely on a combination of blood tests (to look for elevated levels of specific autoantibodies) and small intestine biopsies (to look for characteristic features of celiac disease). These tests must be done while while the patient is still eating a gluten-containing diet. In its Consensus Statement on Celiac Disease, the National Institutes of Health (NIH) has cautioned doctors that, “The single most important step in diagnosing celiac disease is to first consider the disorder.” The NIH issued this warning because symptoms of the disease (e.g., bloating, fatigue, diarrhea, constipation, etc.) could easily blamed on so many other conditions. Indeed, it’s generally believed in the medical community that celiac disease is under-diagnosed in North America – meaning that a lot of people have the disease but don’t realize it. Some studies have estimated that in the U.S., only as few as 1 in 50 or even 1 in 100 cases of celiac disease have actually been diagnosed.