Same symptoms, many possible diagnoses – the way to the correct interpretation of symptoms is not always easy. To diagnose celiac disease causes a fixed sequence.

Celiac disease is based on a disease of the small intestine and is indicated by a hypersensitivity to gluten. These are found in many grains. The disease is chronic and is currently not yet curable. If concerned take gluten-containing foods, inflammation of the small intestinal mucosa. The unpleasant effects are diarrhea, vomiting, loss of appetite, weight loss and fatigue.


Because these symptoms also occur in other intestinal diseases, or even entirely different causes can have a definite diagnosis is possible only through medical tests. Patients may also be affected by the disease varies greatly. Especially in mild cases, people are often unaware that they suffer from celiac disease. Gluten intolerance is known in the population is still too little and too often overlooked by primary care physicians.

The steps of the diagnostic

At the beginning of the in-depth diagnostic survey of the patient is in his history. A physical examination will reveal additional problems. If the tests confirm the initial suspicion of celiac disease, begin medical evidence. These occur in at least two steps: a blood test and a subsequent biopsy of the intestinal mucosa.

Study of antibodies

As a first step of specific antibodies in the blood are examined. This is normally to produce antibodies against IgA (immunoglobulin) or gliadin, a protein reserve of wheat, or to Endomysiumantikorper. The endomysium is a conjunctival tissue that wraps around the muscles. If a certain concentration of these antibodies are detected, the suspicion is confirmed celiac disease. Thus, the investigation is still ongoing but because of security, the diagnosis is confirmed by an intestinal biopsy. The determination of the antibody is confirmed in the course of the disease and gluten-free diet is used as a control, since the number of antibodies should then decrease slowly.

Small bowel biopsy

By means of a small bowel biopsy, the physician examines the lining of the small intestine. This is usually taken by a gastroscopy, a sample from the small intestine. This mucous membrane sample is then examined under a microscope. On the one hand, the structure of the entire mucosa is evaluated, on the other hand, we look for an accumulation of inflammatory cells. It must be also clarified that the inflammation may have only an infectious cause. The biopsy is then judged according to set criteria and made the diagnosis.

Many people shy away from the examination of the intestine by endoscopy. Although it is painless, but the insertion of the endoscope through the mouth is quite unpleasant. A sedative helps the patient to his nervousness, nausea, in addition to the pharynx are stunned. Thus, the investigation is much more pleasant. Also, today only a biopsy during the diagnostic needed before calling the technical guidelines three biopsies in the disease process.

Final Diagnosis

Even after small bowel biopsy to diagnose celiac disease can not make the one hundred percent certainty. Similar conditions and findings arising for example from a food allergy, an infection of the intestines or other immune deficiencies. Normally, however, the course of celiac disease is fairly typical. If in doubt, based on a gluten-free diet, the success of this testing. Complaints from the blades is that celiac disease diagnosis certain.

Once the diagnosis is clear, the patient begins a new life with a gluten-free diet. In no case should be started before the final diagnosis with this, because this would distort the results. Once the small intestinal mucosa has recovered, the symptoms subside and the patient can live pain free. However, he must pay attention to his life long gluten-free diet, because even small amounts can damage the gut again.