Celiac Disease.... Diagnose Process.

Celiac Disease.... Diagnose Process.

The tests for celiac disease are simple – just follow the steps below...

1. Keep eating gluten
Do not commence a gluten free diet prior to being tested for celiac disease. If a gluten free diet has already been adopted, the tests used to diagnose celiac disease are unreliable, and can be falsely negative.
If gluten has been removed from the diet, a normal diet must be resumed for at least six weeks prior to testing. During this ‘gluten challenge’, a minimum of four slices of wheat based bread (or equivalent) should be consumed each day (for adults) (two slices of wheat based bread each day for children). It is important the gluten challenge is carried out properly to ensure reliable test results.


2. Blood tests are used for screening
Blood tests (celiac serology) are used to screen for celiac disease. celiac serology measures antibody levels in the blood which are typically elevated in people with untreated celiac disease, due to the body’s reaction to gluten.
These tests can be less reliable in children under the age of four years, as their antibody levels can fluctuate. It is suggested the antibody tests be performed on two occasions three months apart.
Importantly, a diagnosis of celiac disease SHOULD NOT be made on the basis of a blood test alone. A positive blood test always needs to be followed by a small bowel biopsy to confirm the diagnosis.

3. A small bowel biopsy is essential to confirm diagnosis
A diagnosis of celiac disease can only be made by demonstrating the typical small bowel changes of celiac disease. This involves a gastroscopy procedure in which several tiny samples (biopsies) of the small bowel are taken. A gastroscopy is a simple day procedure done under light anaesthetic sedation that takes about 10 minutes. In the majority of cases, the bowel damage present in those with untreated celiac disease is not visible to the naked eye. The biopsies are examined under a microscope to confirm the presence of villus atrophy.


Archna Shah
archnashahconsultant@gmail.com