Celiac Disease - Sprue

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Diagnosis & Tests

A complete blood count (CBC) may indicate anemia. It is important to determine the cause if anemia is detected. An elevated alkaline phosphatase level may indicate bone loss, which is commonly experienced before diagnosis. Low cholesterol and albumin levels may reflect malabsorption and malnutrition. Mildly elevated liver enzymes and abnormal blood clotting may also be noted.

There are several antibody blood tests that are useful in screening. A panel consisting of Antiendomysial antibody (IgA), Antitransglutaminase (IgA), Antigliadin (IgA and IgG), and total serum IgA is typically ordered. Combined, these antibodies provide a sensitive and specific indicator for the presence of celiac disease.

An EGD (endoscopy) with small bowel biopsy, particularly of distal duodenum and jejunum, the sections of the intestine most commonly affected. This will show an abnormal intestinal lining (some degree of "villous atrophy" -- flattening of the villi).

A follow-up biopsy or blood work may be ordered several months after the diagnosis and treatment. These serve as a final confirmation of the disease. "Normal" results suggest the patient has responded appropriately to treatment, thereby confirming the diagnosis. This does not suggest, however, that the disease has been cured. The treatment for celiac disease is the gluten-free diet.