Why is celiac disease so hard to diagnose

Note, however, that going gluten-free can impact test results, so this must be considered when you are being evaluated. Mention your diet changes to your healthcare provider, as your healthcare provider may recommend you return to a regular diet before testing. You can also consider at-home screening tests for celiac disease, which you can purchase in some stores or online.

These use a finger-prick blood sample that you send to a laboratory, and you receive the results in about a week. If you opt for one of these tests, avoid making changes to your diet in advance, as these results can similarly be affected. A home blood test should always be followed up with medical testing by a healthcare provider. Medical guidelines recommend celiac disease testing for relatives of those diagnosed with celiac disease since the condition runs in families. Familial risk is due to specific genes.

Some people take advantage of consumer genetic testing , such as through 23andMe, to screen for celiac-related genes. This testing does not require being on a gluten-containing diet.

Note, however, that it only shows a risk of the disease, rather than markers of having celiac disease. In most cases, celiac disease blood testing which can be ordered by your primary care healthcare provider will be the first step toward a diagnosis. There are several blood tests commonly used to detect celiac disease, although many healthcare providers will only request one or two of them.

These tests look for various antibodies. If your body is undergoing an autoimmune reaction to gluten, one or more of these blood tests should come up positive.

This indicates that further testing is needed to see if you truly have celiac disease. However, it is possible for you to have negative blood test results and still have celiac disease. Some people have a condition known as IgA deficiency that can cause false-negative results on some celiac disease blood tests. If you have this there's yet another blood test that will look for it , you'll need different tests to screen for celiac disease.

In a few other cases, the blood test results simply don't reflect the amount of intestinal damage present. Therefore, if your blood tests are negative, but your symptoms and family medical history still indicate a strong possibility of celiac disease, you should talk to your healthcare provider about further testing. If you're not eating gluten-containing foods—or not eating enough of them—it's possible for the testing to come up negative, even if you actually do have celiac disease.

It's ideal to continue eating a normal diet, with gluten-containing foods several times a day, until all your testing is completed. If you've already started following a gluten-free diet, you may want to consider what's called a gluten challenge , in which you eat a set amount of gluten for some period of time, and then undergo testing for celiac disease. This approach does carry some risks, though, and may not produce the results you want, so talk to your healthcare provider about the potential pros and cons.

If you have an itchy, painful blistering skin rash called dermatitis herpetiformis , plus positive celiac blood tests, you're officially diagnosed with celiac disease as well—no further testing required. That's because studies have shown that nearly everyone with dermatitis herpetiformis—which, like celiac disease, is caused by an autoimmune reaction to gluten—also has intestinal damage from gluten ingestion.

That said, a positive skin biopsy is the gold standard for confirming dermatitis herpetiformis. This looks for deposits of anti-gluten antibodies under your skin. Your healthcare provider may or may not opt for this testing method.

In some cases, your healthcare provider may recommend genetic testing for celiac disease. Genetic tests can be done using a swab of your mouth or by drawing blood.

As with at-home genetic test kits, what you are currently eating will not affect results of such tests administered in a clinical setting. Genetic tests can't tell you if you actually have celiac disease—for that, you'll need to undergo the blood tests and endoscopy.

If you don't have one of these two main genes, the odds of you having celiac disease are very slim, although some cases of celiac have been documented in people who don't carry either gene.

However, it does mean you possibly can develop the condition. You'll need to discuss with your healthcare provider your next steps if your celiac disease gene test comes back positive, especially if you have a family history of celiac disease.

If your celiac disease blood tests come back positive—or if they're negative, but you and your healthcare provider agree on the need for further testing anyway—your next step is a procedure known as an endoscopy. A doctor obtains biopsies of the small intestine during an upper GI endoscopy.

For an upper GI endoscopy, a doctor uses an endoscope—a flexible tube with a camera—to see the lining of your upper GI tract , including the first part of your small intestine. The doctor passes an instrument through the endoscope to take small pieces of tissue from your small intestine. A pathologist will examine the tissue under a microscope to look for signs of celiac disease.

A doctor may order skin biopsies if you have a rash that could be dermatitis herpetiformis. For skin biopsies, a doctor removes small pieces of skin tissue on and next to the rash.

A pathologist will examine the tissue under a microscope to look for signs of dermatitis herpetiformis. By Scott Adams August 13, By Scott Adams May 5, This site complies with the HONcode standard for trustworthy health information: verify here. View HONcode Certificate. This site places cookies on your device Cookie Settings. Continued use is acceptance of our Terms of Use , and Privacy Policy. This site places cookies on your device Cookie settings.

Continued use is acceptance of our Terms of Use and Privacy Policy. Sign in with Facebook. Followers 0. Journal of Gluten Sensitivity Spring Issue. Go to articles. Recommended Comments. Joyful joanna 1 Posted March 27, Link to comment Share on other sites. Join the conversation You are posting as a guest. Add a comment Those who tested positive for any of the serological tests were given an intestinal biopsy.

All five patients diagnosed According to the poll, nearly 25 percent of sufferers consulted doctors about their symptoms for over a decade, while eleven percent of people with celiac disease sought help from doctors for over 20 years before receiving a proper diagnosis.

People with gluten intolerance and celiac disease often suffer from persistent diarrhea, bloating and abdominal pain that is triggered by the body's immune system fighting In fact, the most common medical issues for people with celiac disease might really surprise you. A team of researchers who recently looked at data on celiac patients admitted to S.

Notably, two out of three people with celiac disease show non-classical symptoms. Hashimoto's thyroiditis attacks and destroys the thyroid cells, and is the most common cause of hypothyroidism in the U. Signs and symptoms of Hashimoto's disease include constipation, fatigue, sluggishness, depression, muscle weakness, pain and stiffness in the joints, unexplained weight gain, and a hoarse voice. An upper endoscopy is performed using gentle sedation. It involves inserting a long, flexible tube, called an endoscope, down your throat and into your esophagus.

A tiny camera on the end of the endoscope allows your doctor to see your esophagus, stomach and the beginning of your small intestine.

During the endoscopy, your doctor may take several tissue samples — this is called a biopsy. Those samples are later examined under a microscope to see if they show any damage.

In particular, damage to the tiny finger-like projections that line the small intestine, called villi, may be a sign of celiac disease. For example, some people have gluten sensitivity that is not related to celiac disease.