How is Celiac Disease diagnosed?

Recognizing celiac disease can be difficult because some of its symptoms are similar to those of other diseases. Celiac Disease can be confused with irritable bowel syndrome, iron-deficiency anemia caused by menstrual blood loss, inflammatory bowel disease, diverticulitis, intestinal infections, and chronic fatigue syndrome. As a result, Celiac Disease has long been underdiagnosed or misdiagnosed. As doctors become more aware of the many vaired symptoms of the disease and reliable blood tests become more available, diagnosis rates are increasing.

Blood Tests

People with Celiac Disease have higher than normal levels of certain autoantibodies, proteins that react against the body’s own cells, or tissues in their blood. To diagnose Celiac Disease, doctors will test blood for high levels of anti-tissue transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA). If test results are negative but Celiac Disease is still suspected, additional blood tests may be needed.

Intestinal Biopsy

If blood tests and symptoms suggest Celiac Disease, a biopsy of the small intestine is performed to confirm the diagnosis. During the biopsy, the doctor removes tiny pieces of tissue from the small intestine to check for damage to the villi. This process is known as an endoscopy.

Dermatitis Herpetiformis

Dermatitis Herpetiformis (DH) is an intensely itchy, blistering skin rash. Some people with DH have no digestive symptoms of Celiac Disease.

DH is diagnosed through blood tests and a skin biopsy. If the antibody tests are positive and the skin biopsy has the typical findings of DH, patients do not need to have an intestinal biopsy. Both the skin disease and the intestinal disease respond to a gluten-free diet and recur if gluten is added back into the diet.


Screening for Celiac Disease means testing for the presence of autoantibodies in the blood in people without symptoms. Americans are not routinely screened for Celiac Disease. However, because Celiac Disease is hereditary, family members of a person with the disease may wish to be tested.