How to know if you have celiac disease

Medically reviewed on June 14, 2022 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• What is celiac disease?
• Is celiac disease an allergy?
• Celiac disease symptoms
• How is celiac disease diagnosed? Testing for celiac disease
• What causes celiac disease?
• How common is celiac disease?
• How is celiac disease treated?
• Celiac disease screening with Everlywell
• Related content

Celiac disease is an autoimmune disorder that inhibits the body’s ability to process gluten. In addition to causing acute and chronic digestive distress, celiac disease can also cause major damage to the small intestine.

Fortunately, people with celiac disease can find solace and optimal health by adopting a gluten-free lifestyle and staying away from gluten-rich foods and products. However, the key to finding relief and wellness with celiac disease starts by confirming you have it (which a Celiac Disease Screening Test may help with).

In this guide, we’ll discuss how to know if you have celiac disease and how to adapt habits if you do.

What is celiac disease?

Celiac disease is a chronic autoimmune disorder that primarily affects the small intestine. It arises when an individual is unable to digest gluten, a type of protein found in foods like [1]:

• Wheat
• Rye
• Barley

There are many foods to avoid with celiac disease. When people with celiac disease are exposed to gluten, their immune cells target the villi lining the small intestine—anemone-like structures, which normally absorb proteins and other nutrients in food. This causes the villi to atrophy and flatten out, undermining their ability to digest other food that travels down the digestive tract [1].

When the small intestine is damaged, it can cause a cascade of other impediments to the digestive system and other systems of the body, especially if left untreated. Because there is no cure for celiac disease, it’s critical for individuals with celiac to adapt to a diet free of gluten-containing foods to take care of their digestive and overall health.

Learn More: What foods to avoid with celiac disease

Is celiac disease an allergy?

While often confused for a wheat allergy, celiac disease is not a food allergy.

There are two main differences between food allergies and celiac disease:

• Type of reaction – Food allergies occur when antibodies mistakenly regard food antigens as a threat to the body. This primarily involves the antibodies known as IgE. When triggered, these antibodies set off a chain inflammatory reaction by flooding the bloodstream with histamines that alert the body’s cells to a perceived threat [2]. While both allergies and celiac disease involve the immune system, a different class of antibodies—immunoglobulin IgA—are the primary actors in individuals with celiac [3].
• Organs affected – While food allergies can affect multiple organs and systems of the body at once, celiac disease chiefly targets and can cause structural damage to the small intestine. Symptoms of celiac disease are predominantly digestive, though they can set off a cascade of secondary symptoms if left untreated.

Celiac disease is also commonly confused with gluten intolerance, a condition suspected to affect around 6% of people [4].

Where celiac disease directly impacts and injures the small intestine, gluten intolerance does not necessarily result in structural damage to the digestive system. That said, gluten intolerance can still be painful, and in many cases, it may result in physical and cognitive symptoms akin to celiac disease [5].

Celiac disease symptoms

The hallmark signs of celiac are concentrated in the digestive system. People with celiac may experience [6]:

• Abdominal pain
• Bloating
• Gas
• Nausea
• Vomiting
• Diarrhea
• Constipation
• Weight loss
• Fatigue

Because celiac disease is a chronic illness, symptoms may worsen and spread to other physical systems of the body. Over time, celiac disease may result in [7]:

• Headaches
• Fatigue
• Brain fog or inability to concentrate
• Depression or anxiety [8]
• Itchiness, rash, or blistering
• Mouth ulcers
• Anemia
• Osteoporosis or bone-softening (osteomalacia)
• Joint pain
• Nervous system-related issues, like numbness, loss of balance, or cognitive decline

Finally, the manifestations of celiac disease may vary with age. Celiac disease can impede development in young children by delaying growth or puberty onset [8].

How is celiac disease diagnosed? Testing for celiac disease

Health care professionals have developed an effective diagnostic sequence for determining whether an individual has celiac disease:

• Serological testing – Serology tests are a type of blood test that chiefly measure two types of antibodies in the bloodstream: transglutaminase and IgA anti-endomysial antibodies. Both are implicated in how the body’s immune system treats gluten proteins, and people with celiac may exhibit heightened levels of both [9, 10].
• Genetic testing – Certain genetic components are associated with celiac disease. Genetic screening for celiac usually addresses the presence of HLA (human leukocyte antigen), a gene that plays a key role in immune system regulation. Research has demonstrated that people with celiac disease often have higher levels of certain types of HLA than people who have no gluten sensitivity [11].

If these blood tests indicate the possible presence of celiac disease, your healthcare provider may advise undergoing an endoscopy to examine for any discernible damage to the small intestine.

There are two ways a healthcare provider may administer an endoscopy [12]:

• Standard endoscopy – During this type of endoscopy, a tube with a camera attached to it is inserted into the throat. Your healthcare provider will use this apparatus to retrieve a tissue sample from the small intestine for biopsy. The biopsy can then determine whether the villi in the small intestine have been impaired.
• Capsule endoscopy – In this type of endoscopy, you will swallow a capsule that contains a camera. This camera will take pictures of the digestive tract as it passes through the body, giving your healthcare provider a closer look at any structural damage to the small intestine.

What causes celiac disease?

Celiac disease is genetic, which means it tends to cluster in families [13]. So if a parent is diagnosed with celiac, you’re more likely to have it.

To that end, if a parent routinely experiences adverse digestive reactions to gluten-rich foods, they may have undiagnosed celiac disease. While testing for food sensitivities may have been inaccessible in the past, medicine has come a long way over the past few decades, making testing for gluten-related issues even more accessible to individuals looking to take their well-being into their own hands.

How common is celiac disease?

Some 2 million Americans are diagnosed with celiac disease, though some researchers believe many people live with the condition without knowing it [13]. Since it’s impossible to observe small intestine damage without a diagnostic test, celiac disease often gets mistaken for routine digestive upset.

Moreover, the incidence of celiac disease is higher within the following demographics [13]:

• People with European ancestry
• People with autoimmune disorders
• People who struggle with fertility
• People with IBS (irritable bowel syndrome)
• People who have Down syndrome

How is celiac disease treated?

There is currently no treatment that can improve the small intestine’s ability to process gluten. However, gluten-free diets are highly effective at restoring healthy digestive function for people with celiac. By eliminating foods containing gluten, many people with celiac can make substantial gains in recovery and go on to live nourished, fulfilling lives [14].

Often, the most difficult part of adhering to a gluten-free diet is steering clear of “hidden gluten.” Even if you’re avoiding traditional bread, some products may contain trace amounts of gluten, including [14]:

• Nutritional supplements
• Vitamins
• Prescription medicines
• Cosmetics
• Toothpaste or mouthwash
• Skincare products
• Hair care products
• Play-Doh

If you have celiac disease, the best course of action is to look for “gluten-free” labeling when shopping for common household products. Additionally, you can ask your pharmacists to confirm that any medications you’re prescribed are certifiably gluten-free.

Even when you take the appropriate precautions, you may find it challenging to exclude gluten from the diet—especially if you have a taste for carbohydrate-rich foods. Fortunately, there are many gluten-free alternatives for familiar food staples available to people with celiac disease, from pastas to sandwich bread.

Celiac disease screening with Everlywell

To check for antibodies that may indicate celiac disease, try the Everlywell at-home Celiac Disease Screening Test. This test checks 3 key antibodies (including total IgA) to help aid in the diagnosis and management of celiac disease. For test results indicating increased risk of celiac disease, our patient care team will reach out to you about next steps.

Related content

What Foods to Avoid With Celiac Disease

Crohn’s vs. Celiac

The Link Between Celiac Disease and Anemia

Meet Our First At-Home Food Allergy and Celiac Disease Screening Tests

References

1. Caio G, Volta U, Sapone A, Leffler DA, De Giorgio R, Catassi C, Fasano A. Celiac disease: a comprehensive current review. BMC Med. 2019 Jul 23;17(1):142.

2. Histamine: The Stuff Allergies are Made of. MedlinePlus. URL. Accessed June 14, 2022.

3. Immunoglobulin A. British Society for Immunology. URL. Accessed June 14, 2022.

4. Gluten allergy. National Celiac Association. URL. Accessed June 14, 2022.

5. Non-Celiac Gluten/Wheat Sensitivity. Celiac Disease Foundation. URL. Accessed June 14, 2022.

6. Symptoms & Causes of Celiac Disease. National Institute of Diabetes and Digestive and Kidney Diseases. URL. Accessed June 14, 2022.

7. Celiac disease. Mayo Clinic. URL. Accessed June 14, 2022.

8. Gluten and Celiac Disease. National Institute of Diabetes and Digestive and Kidney Diseases. URL. Accessed June 14, 2022.

9. Celiac Disease. StatPearls [Internet]. URL. Accessed June 14, 2022.

10. Anti-Endomysial Antibody (EMA). National Health Service. URL. Accessed June 14, 2022.

11. Human Leukocyte Antigen and its Association with Celiac Disease and Associated Autoimmune Diseases. Journal of Gastroenterology and Hepatology Research. URL. Accessed June 14, 2022.

12. Celiac disease – Diagnosis. Mayo Clinic. URL. Accessed June 14, 2022.

13. Celiac Disease. Johns Hopkins Medicine. URL. Accessed June 14, 2022.

14. Treatment for Celiac Disease. National Institute of Diabetes and Digestive and Kidney Disease. URL. Accessed June 14, 2022.