Center for Celiac Research: Talking to Your Doctor

How to talk with your doctor about celiac disease, including recommended blood tests for celiac disease, misdiagnoses and more.

According to research from the Center for Celiac Research, 1 in 133 people in the United States have celiac disease, with the vast majority still undiagnosed. A celiac disease diagnosis (unlike many other diseases) does not have to start with your physician’s suspicions.

If you suspect that you might have celiac disease and other conditions have been ruled out, make an appointment with your primary care physician for blood work.

There is a particular series of blood tests called the “Celiac Panel.” These tests measure your immune system’s response to gluten in the food you eat.

•  tTG-IgA or tissue transglutaminase-IgA

•  AGA-IgG or Antigliadin IgG

•  AGA-IgA or Antigliadin IGA

•  Total IGA

The presence of tTG antibodies is highly suggestive of celiac disease, while AGA can be elevated also in cases of wheat allergy.

The current diagnostic tests for celiac disease are very accurate, particularly when tTG and anti-endomysial antibodies are elevated. The isolated presence of anti-gliadin antibodies does not necessarily imply that the subject is affected by celiac disease, with the exception of children under the age of 2 in which tTG and EMA may not be present.

If the results of the antibody tests are positive, or your doctor suspects celiac disease, you should next see a gastroenterologist to undergo a small intestine tissue biopsy (endoscopy).

A biopsy showing damaged villi in the small intestine is the next step in the diagnosis of celiac disease.  Improvement of health with the gluten-free diet is the final step in the diagnosis of celiac disease.

Top five misdiagnoses for overlooked celiac disease:

1.  Anemia

2.  Irritable Bowel Syndrome

3.  Psychological stress, nerves, “imagination”

4.  Diarrhea

5.  Inflammatory Bowel Disease

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