For the diagnosis of celiac disease, different tests are needed. As they all have some pitfalls, it is sometimes difficult to reach a diagnosis for celiac disease.
When symptoms indicate celiac disease, testing usually starts with taking a blood sample. When the blood test points towards celiac disease, the suspicion usually needs to be confirmed by an endoscopy with biopsies. This procedure allows the doctor to take a look inside a patient’s intestine and to take tiny samples from the intestinal mucosa, which are then examined under a microscope. With this procedure, the doctor can see if there is tissue damage and inflammation typical for celiac disease. Other tests only have to be performed under special conditions. In children with suspicion for celiac disease, diagnosis may be made without biopsy in some cases, but several conditions must be met.
Sometimes, all symptoms point towards celiac disease while the tests are negative. In this case, it is possible that someone experiences symptoms related to wheat or gluten that are not due to celiac disease. These conditions also need to be confirmed or ruled out by a doctor.