• Diagnosis of Celiac Disease

    Your doctor will ask about your symptoms and medical history and perform a physical exam. Because the symptoms of celiac disease are often very similar to those of other conditions, it can be difficult to obtain an accurate diagnosis early on. However, early diagnosis of celiac disease is very important because the earlier you start the gluten-free diet, the less likely you are to have advanced damage to your intestinal tract. Maintaining a gluten-free diet is very important to help prevent complications caused by celiac disease.
    Your doctor may suspect celiac disease:
    • In a child—if the child eats well but still shows signs of malnutrition (especially if there is a family history of the disease)
    • In an adult—if you have dermatitis herpetiformis (a gluten-sensitive skin rash), gastrointestinal symptoms, evidence of iron deficiency, signs of vitamin deficiency, or a family history of the disease.
    If celiac disease is suspected, tests will be done to confirm the diagnosis. Tests include:
    Blood Tests —a blood sample is taken to check for:
    • The presence of certain antibodies to gluten, which are produced by the immune system
    • Evidence of malabsorption of nutrients, such as anemia and vitamin and mineral deficiencies
    Endoscopy —a thin, lighted tube inserted down the throat to examine and biopsy the intestine
    Endoscopy
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    Biopsy —Performed via an endoscope to confirm the diagnosis of celiac disease. It requires the removal of a small sample of tissue from the small intestine during endoscopy to test for flattened and damaged villi. If the biopsy shows signs of celiac sprue, you may be put on a gluten-free diet for about 3-6 months. After that time, a second biopsy may be done to look for signs of improvement, such as positive changes in the villi of the small intestine.

    References

    American Academy of Family Physicians website. Available at: http://www.aafp.org/ . Accessed March 9, 2006.

    Mayo Foundation for Medical Education and Research website. Available at: http://www.mayo.edu/ . Accessed March 9, 2006.

    The Merck Manual of Medical Information, 17th ed. Simon and Schuster, Inc.; 2000.

    National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/ . Accessed March 9, 2006.

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