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Celiac Disease: Signs, Testing and Living Gluten-Free
- Comprehensive Gastroenterology P.A.
- October 21, 2026
- 7 min read
Quick Answer
Celiac disease is an autoimmune condition in which eating gluten, a protein in wheat, barley and rye, triggers the immune system to damage the lining of the small intestine. It affects about 1 in 100 people, and many do not know they have it. Diagnosis usually starts with a blood test and is confirmed with an upper endoscopy and biopsy. Keep eating gluten until testing is complete.
Celiac Disease at a Glance
What Happens in Celiac Disease?
The small intestine is lined with tiny, finger-like projections called villi that absorb nutrients. In celiac disease, gluten triggers an immune reaction that flattens these villi, making it harder for your body to absorb vitamins, minerals and calories.
From Gluten to Intestinal Damage
Found in foods made with wheat, barley or rye.
In people with celiac disease, the body treats gluten as a threat.
Inflammation flattens the lining of the small intestine.
This can lead to anemia, bone loss, fatigue and other problems.
On a strict gluten-free diet, the intestine can heal over months.
Common Signs and Symptoms
Celiac disease looks different in every person. Some have digestive symptoms, others have none at all.
| Digestive Symptoms | Other Symptoms and Signs |
|---|---|
| Diarrhea or loose stools | Iron-deficiency anemia |
| Bloating and gas | Fatigue and brain fog |
| Abdominal pain | Itchy, blistering skin rash (dermatitis herpetiformis) |
| Constipation | Bone thinning (osteopenia or osteoporosis) |
| Nausea | Mouth ulcers, headaches, joint pain |
| Unintended weight loss | Delayed growth in children; fertility problems |
Who Should Be Tested?
Consider Testing If You Have
How Celiac Disease Is Diagnosed
Testing Step by Step
Important: keep eating gluten until all testing is complete
A tissue transglutaminase IgA (tTG-IgA) test, often with a total IgA level.
If the blood test is positive or suspicion is high, a gastroenterologist reviews your results.
Small samples from the duodenum confirm the diagnosis.
Start a strict gluten-free diet and check vitamin, iron and bone health.
Repeat blood tests confirm the diet is working.
Starting a gluten-free diet before testing can cause false-negative results, so talk with your doctor first.
Gluten-Free Food Guide
| Usually Safe | Avoid | Check the Label |
|---|---|---|
| Fresh fruits and vegetables | Wheat, including spelt, durum and semolina | Oats (choose certified gluten-free) |
| Meat, poultry, fish and eggs | Barley and malt | Sauces, gravies and soy sauce |
| Rice, quinoa, corn, potatoes | Rye | Soups, seasonings and processed meats |
| Milk, cheese and plain yogurt | Regular bread, pasta, crackers and cereal | Candy, snacks and salad dressings |
| Beans, nuts and seeds | Most beer | Medications and supplements |
Look for a certified gluten-free label. A dietitian experienced in celiac disease can help you plan meals.
Avoiding Cross-Contact at Home
- Use a separate toaster or toaster bags.
- Keep separate spreads such as butter and peanut butter to avoid crumbs.
- Clean surfaces and utensils before preparing gluten-free food.
- Ask questions when eating out about shared fryers and preparation.
Celiac Disease Care in Denton
Dr. Amjad Awan diagnoses and manages celiac disease for patients across Denton County. Call (940) 243-0912, request an appointment, or learn about upper endoscopy in Denton.
Frequently Asked Questions
Is celiac disease the same as gluten intolerance?
No. Celiac disease is an autoimmune condition that damages the intestine. Non-celiac gluten sensitivity can cause symptoms but does not cause the same intestinal damage.
Can celiac disease develop in adults?
Yes. Celiac disease can be diagnosed at any age, including in older adults.
How long does it take to heal?
Many people feel better within weeks, but full healing of the intestine can take months to a few years.
Can I eat a little gluten occasionally?
No. Even small amounts of gluten can cause intestinal damage in people with celiac disease, even without symptoms.
Is celiac disease hereditary?
It runs in families. First-degree relatives of someone with celiac disease have a higher risk and may benefit from testing.
Disclaimer: This article is for general education and does not replace professional diagnosis or treatment. If you have symptoms or questions about your digestive health, please talk with a qualified healthcare provider.
Contact Our Office
Dr. Awan has cared for patients in Denton County for 25 years with Comprehensive Gastroenterology P.A. He provides colonoscopy, upper endoscopy, ERCP, endoscopic ultrasound and treatment for the complete range of digestive, liver and pancreatic conditions, with a focus on clear explanations and personal care.
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