Celiac Disease Diagnosis

Celiac disease creates a problem in the diagnosis stage. Although Celiac disease is virtually asymptomatic, a tissue biopsy of the small intestine serves as the best way to diagnose this condition.

Blood Tests

As celiac disease is the body’s immune response to the ingestion of gluten, the immune system produces specific antibodies to ward off that gluten. Thus, a blood test that shows anti-endomysial antibodies and transglutaminase antibodies would strongly suggest the existence of celiac disease. That’s why laboratory testing is a solid, sound place to begin a diagnostic process for celiac disease. But the process is far from finished at this point.

Tissue Biopsy

The best way to confirm the presence of celiac disease is by a close and comprehensive examination of the small intestine. Celiac disease and gluten intolerance result in damage to the villi of the small intestine, a condition called villous blunting. To diagnose celiac disease with confidence, doctors perform a tissue biopsy of the small intestine.

The biopsy of intestinal tissue is performed with an endoscope, a small, thin, very flexible tube that doctors insert into the mouth. They snake it through the esophagus and the stomach, ultimately reaching the small intestine where a select patch of the villous lining is scraped up and removed for analysis by a pathologist.


Another way to diagnose celiac disease is to put the patient on a gluten-free diet. If the more prevalent symptoms of celiac disease (diarrhea, bloating, anemia) begin to subside after a minimal, specified period of time, it is reasonable to assume that the patient does indeed have celiac disease.

Most important, this diet-related option should be pursued only after a complete medical evaluation. Otherwise, the test results might reveal a false negative. In other words, the tests may incorrectly indicate that celiac disease is not present.

Reduction in symptoms on a gluten-free diet does not indicate a definitive celiac disease diagnosis. The only definitive diagnosis can be made thorough a villous tissue biopsy.


Beers, M.H.