Since celiac disease has symptoms that are common with other digestive disorders such as irritable bowel syndrome, a physical exam alone isn’t enough to diagnose the disease. Doctors will also review the patient’s family medical history to determine whether anybody has been diagnosed with celiac disease. Genetic testing is also often performed to look for gene variants linked to increased disease risk. The only way to confirm a diagnosis of celiac disease is through the detection of specific antibodies in the blood and confirmation of damage to villi (tiny nutrient-absorbing structures) in the small intestine through a biopsy.[1] It is important to note that a positive diagnosis is only possible after gluten exposure for several weeks before the test. People on gluten-free diets may be advised by their physician to start a “gluten challenge,” which involves several weeks of continuous gluten exposure, since elimination of gluten from the diet can lead to a false-negative diagnosis.[2]
How is celiac disease diagnosed?
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•Last Updated: May 16, 2025
Celiac disease is diagnosed through a combination of a physical exam, family medical history review, genetic testing, and the detection of specific antibodies in the blood, along with a biopsy to confirm damage to the small intestine's villi. A positive diagnosis requires prior gluten exposure for several weeks, and people who are on gluten-free diets may need to undergo a "gluten challenge" to avoid false-negative results.