Celiac Disease FAQ

Q: How is celiac disease diagnosed?

A: Celiac disease is typically screened for by an antibody blood test, such as antibodies for tissue transglutaminase (tTG), and if positive an endoscopic biopsy will be needed to confirm.

Q: What triggers celiac disease?

A: There is no confirmed single trigger of celiac disease. It is thought that celiac disease requires three things: genetic predisposition, an over-responsive immune system, and individual environment. Environmental triggers include gluten itself, as well as other things such as length of breast-feeding and traumatic/stressful events. How strongly these environmental triggers relate to celiac disease is still being researched.

Q: Is it necessary to have an intestinal biopsy to confirm the diagnosis of celiac disease?

A: The intestinal biopsy is the gold standard for the diagnosis of celiac disease, and therefore is considered essential.

Q: Can I outgrow celiac disease?

A: If you are a biopsy proven celiac, you will not outgrow the disease since celiac disease is an autoimmune disorder like diabetes and rheumatoid arthritis

Q: Is celiac disease a food allergy?

A: No, celiac disease is not a food allergy; rather it is an autoimmune disease. Food allergies, including wheat allergy, are conditions that people can grow out of. This is not the case with celiac disease.

Q: I feel better on a gluten-free diet. Can I just assume I have celiac disease?

A: No. There are other possible causes for improvement on a gluten-free diet. Always refer to a medical professional when making a clinical diagnosis.

Q: Should I be eating gluten before my blood test?

Yes, you should be eating a normal diet containing gluten. If you have been on a gluten-free diet for a few weeks or more, you should start a “gluten challenge” as directed by your Gastroenterologist. A gluten challenge is the reintroduction of gluten into the diet. For blood tests, you will typically need to go on a gluten challenge for 2 to 3 months. If you experience symptoms immediately after reintroducing gluten, speak to your Gastroenterologist about the possibility of a shorter gluten challenge (a week to two weeks) followed by an endoscopic biopsy.

Q: If I have celiac disease but no symptoms, can I still eat gluten?

A: No, if you have celiac disease you cannot eat gluten even if you have no symptoms. The ingestion of gluten still damages the intestines and also increases your risk for various complications like cancers and osteoporosis.

Q: What are the chances that others in my family have celiac disease since I’ve been diagnosed with it?

A: The prevalence of celiac disease in 1st and 2nd degree relatives of someone already diagnosed with the disease is significantly higher than in the general population. It is estimated that among 1st degree relatives (children, parents, siblings), the prevalence rate is between 4% and 16% (1 in 25 and 1 in 6) while among 2nd degree relatives (aunts, uncles, grandparents), the rate is about 2.6% or 1 in 38.

Q: Can I use products like shampoos or lotions that contain gluten if I have celiac disease?

A: Gluten must be ingested for it to be cause for concern for someone with celiac disease.  However, we still recommend you avoid any products that have the potential to be ingested.

Q: What is gluten sensitivity?

A: Non-celiac gluten sensitivity (NCGS) is the condition which is diagnosed when celiac disease and wheat allergy have both been ruled out but the patient still improves on a gluten-free diet. A lot about this condition and treatments is still unclear.

REMINDER: This information is intended to provide general information and should not be used to base a diagnosis or treatment. Please consult the doctors about your specific condition and the approach for treatment.