Celiac Disease: A Practical Checklist
Celiac Disease: what is worth doing, what is worth avoiding, and when to stop and see a doctor.
An autoimmune condition in which gluten damages the lining of the small intestine. It is substantially underdiagnosed, and removing gluten before testing makes the diagnosis much harder to establish.
Key takeaways
- Trigger: gluten, found in wheat, barley and rye
- Testing: blood tests, then usually an upper endoscopy with biopsy
- Most useful single change: Ask for testing before removing gluten from your diet.
- Commonest mistake: Going gluten-free before testing, which can make results falsely normal.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
Do
- Ask for testing before removing gluten from your diet
- Keep eating gluten regularly until tests are done
- Ask for a referral to a registered dietitian after diagnosis
- Encourage parents, siblings and children to ask about testing, as they are at higher risk
Do not
- Going gluten-free before testing, which can make results falsely normal
- Assuming "may contain" products are safe
- Oats not labeled gluten-free, which are often cross-contaminated
The numbers behind the list
Every item above comes from these figures, published in the guidance listed at the foot of the page.
| Measure | Figure |
|---|---|
| Trigger | gluten, found in wheat, barley and rye |
| Testing | blood tests, then usually an upper endoscopy with biopsy |
| Crucial | keep eating gluten until testing is complete |
| Management | a strict lifelong gluten-free diet |
| Gluten-free labeling | FDA rules require less than 20 parts per million of gluten |
If you change one thing
Ask for testing before removing gluten from your diet. It is first on the list above. If the rest feels like too much at once, start there and leave the others.
Related topics
- The Evidence on Anemia, Without the Hype (Blood Health)
- The Evidence on Dietary Fiber, Without the Hype (Nutrition)
- Gut Health and Immunity: What the Evidence Actually Says (Immunity)
- Mouth Ulcers: What Published Guidance Supports (Oral Health)
Where to go next
- Celiac Disease: What Published Guidance Supports
- Celiac Disease, Explained Without the Jargon
- Celiac Disease — the reference entry
- Digestive Health: The Complete Guide
- Bloating: Sorting the Evidence From the Noise
- What the Guidance Really Says About Diarrhea
When to speak to a doctor
See your doctor for persistent diarrhea, bloating, unexplained weight loss, mouth ulcers, fatigue or iron-deficiency anemia. Do not remove gluten before testing. Go to the emergency room or call 911 for severe abdominal pain, persistent vomiting or significant blood in the stool.
Where this comes from
- National Institute of Diabetes and Digestive and Kidney Diseases — Celiac Disease
- FDA — Gluten-Free Means What It Says
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.
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