If antibody tests and/or symptoms suggest celiac disease, a physician should establish the diagnosis by obtaining tiny pieces of tissue from the small intestine to check for damage to the villi. This is done via endoscopic biopsy. Under sedation, the physician eases a long, thin tube called an endoscope through the mouth and stomach into the small intestine. Then, he takes tissue samples using instruments passed through the endoscope.
New guidelines in 2011 allow for diagnosis without a biopsy, but only in very rare cases. In these rare cases at least one of the genes must be present, both tTG and EMA blood tests must be more than 10x normal, and there must be a positive response to a gluten-free diet.
Read our Factsheet, “Diagnosing Celiac Disease
,” to learn more. March, 2016