Celiac Disease

At your first appointment, we’ll ask about your symptoms. We want to get to know you and learn about your experience. We’ll also want to know if any other family members have celiac disease or conditions that could be related, like Type 1 diabetes or thyroid disease. This information gives us valuable information about your risk of having celiac disease.

Next, you’ll get a physical exam. We’ll look for visible signs of celiac disease, like skin rashes or bloating in your belly. And we’ll ask if you have other symptoms, like tingling in your legs, muscle cramps and joint issues or diarrhea.

We may also do tests to rule out other conditions, like gluten intolerance, that could be causing your symptoms. It’s important that you don’t cut gluten out of your diet before taking these tests so we can see what effects gluten has on you.

Blood tests

We’ll take a blood sample using a needle and a syringe and send it to our lab. Our pathologists (tissues specialists) will then check the sample to see if it has high levels of specific antibodies or celiac-related health issues, such as anemia (low blood count) or hepatitis (liver inflammation).

Genetic tests

Using a swab, we’ll take a small sample of cells from inside your cheek. Our genetic experts will then look at your DNA in the sample to see if there are signs of gene changes that could be a sign of celiac disease.

Skin biopsy

If you have a rash, we may take a small sample of your skin and send it to the lab. Using this sample, our pathologists can determine if the rash could be dermatitis herpetiformis, a reaction to gluten.

Small intestine biopsy

During a small intestine biopsy, our specialists use upper endoscopy to guide a thin tube with a camera (endoscope) through your mouth and into your small intestine. They’ll remove small pieces of tissue for testing to see if there’s damage to any of your villi (small, finger-like projections that move nutrients through your small intestine to your blood).

Our team has decades of experience doing endoscopies, and we focus on your comfort before, during and after the test. You’ll be sedated or given another type of anesthesia before the test so you won’t feel any pain or discomfort.

Meet Your Team of Healthcare Providers for Celiac Disease

Your care team will work together to confirm that you have celiac disease and then personalize your treatment. Your team could include:

• Gastroenterologists
• Pathologists (tissue specialists)
• Dietitians
• Rheumatologists
• Endocrinologists
• Psychologists

Treatment always includes avoiding gluten. Once you drop gluten from your diet, things can start improving quickly — sometimes within a few days. But it can take villi months to years to fully heal — sometimes up to three years in adults.

At Cleveland Clinic, we go beyond getting rid of gluten. We offer whole-person care that helps you improve both physically and emotionally.

Complete nutritional support

Our experienced dietitians will help you put together a personalized diet plan that meets your nutritional needs and prevents vitamin and mineral deficiencies, like vitamin D. They’ll check in with you often to make sure your diet is working for you and adjust things as needed to keep you feeling your best.

Lifelong follow-up care

While your custom treatment plan sets you up for success, you’ll still need to see us regularly to check on your small intestine and your overall health. We’ll want to see you every three months at first, then every six months and eventually every year.

Support for going gluten-free

It’s important to remain gluten-free for life because even a small amount can damage your small intestine and restart all of your problems. We know making big changes like this can be hard, but your care team will walk you through every aspect of living life gluten-free.

You’ll learn what foods to stay away from and what products (like some toothpastes, cosmetics and even medications) have gluten in them. You’ll also learn about cross-contamination (when gluten-free products accidentally come into contact with gluten).

Mental health support

We know it can be exhausting and stressful to face a chronic issue like celiac disease. That’s why your care team includes mental health professionals who treat depression, anxiety and other conditions. We can also give you information on resources and support groups so you can connect with others with celiac disease.

Taking the Next Step

Tackling celiac disease head-on means you’ll have to make some big changes to the way you live — and eat. But adjusting to a gluten-free lifestyle doesn’t have to hold you back from the things you love or leave you stressed. We’re here to help you feel great about your life and your health, now and for years to come.