Celiac Disease Diagnosis and Treatment

How to make a celiac disease diagnosis

Testing for celiac disease usually includes a combination of history and physical exam (clinic appointment), blood testing, endoscopy or a combination of the above mentioned.

Blood Testing

Usually first steps in the diagnosis of children with celiac disease includes blood testing. People with celiac disease have higher levels of  antibodies in their blood than those without celiac.

Some of the antibodies we may test for in diagnosing your child would include:

  • Tissue transglutaminase IgA and Immunoglobulin A level
  • Endomysial antibody
  • Antidamidated gliadin peptide

Please note that blood testing is less accurate if you are already on a gluten-free diet.

Genetic testing can be helpful though it is important to know that a large percentage of the population has the genes for celiac disease without actual signs of the disease. That said, genetic testing can be helpful to confirm that one is truly susceptible to celiac.

Endoscopy with biopsy is a confirmatory testing for celiac disease. In an endoscopy, while you or your child are asleep, a endoscope (small camera with a light on the end) is placed into the mouth, down the throat into the esophagus, stomach an small intestine. Biopsies, or small pieces of tissues, are taken during the endoscopy, and looked at under the microscope to confirm diagnosis of celiac disease.

It is important to know that the diagnostic testing mentioned above requires gluten ingestion. If/when someone is no longer taking gluten the diagnostic testing will lose accuracy.

Treatment for celiac disease

Celiac disease treatment is life long adherence to a gluten-free diet.

In the majority of cases, adherence to a strict gluten-free diet is all that is necessary to treat celiac disease.  It usually takes between 6 months and 2 years for most people’s intestines to fully to improve after strict adherence to a gluten-free diet. It is a process to implement this life style change into peoples’ lives, however, most families supporting a child or family member with celiac disease find it to be safer, more beneficial and supportive when the entire family understands and puts into practice the elimination of gluten cross-contamination throughout the home.

A necessary part of treatment for celiac disease is meeting with our registered dieticians who have extensive expertise with the disease and understand the special nutritional needs that accompany a 100 percent gluten-free diet.

Some of the important topics that our registered dieticians will discuss with your family are:

  • How much gluten is too much on a gluten-free diet?
  • Can gluten be found in products other than food?
  • Multivitamins and medications—are they gluten-free?
  • Overall nutritional intake and fiber needs when subscribed to a gluten-free diet
  • Type 1 Diabetes and the connection to celiac disease
  • Guide for the gluten-free diet

Do all people respond to gluten-free diets?

The majority of patients diagnosed with celiac disease respond well to a gluten-free diet. In some cases however, the perceived lack of response is due to an inadvertent consumption of gluten on the part of the patient, most likely due to cross-contamination. Gluten can be found in many non-food products, as well. In the case of treating refractory celiac disease patients, their diets should be carefully reexamined due to the likelihood of gluten contamination or exposure still taking place.

Note: In August of 2013, the U.S. Food and Drug Administration (FDA) issued a regulation that defines the term “gluten-free” for food labeling. Learn more about the "gluten-free" regulation >