Celiac Disease
What Is It?
Autoimmune disorder triggered by gluten ingestion in genetically susceptible individuals, causing small intestinal inflammation, malabsorption, and systemic symptoms (GI, dermatologic, neurologic, reproductive).
How Is It Diagnosed?
Anti-tTG IgA (most sensitive), total IgA to exclude IgA deficiency. Small bowel biopsy via upper endoscopy (gold standard - do NOT start gluten-free diet before biopsy). HLA-DQ2/DQ8 genetic testing.
How Is It Treated?
Strict lifelong gluten-free diet is the only treatment. Nutritional rehabilitation (iron, B12, folate, vitamin D, calcium). Dietitian consultation essential. Annual follow-up with labs and tTG-IgA.
Tests and Imaging Typically Needed
Anti-tTG IgA, total IgA, anti-EMA, anti-DGP, HLA-DQ2/DQ8, CBC, iron studies, B12, folate, vitamin D, BMP, upper endoscopy with biopsy.
Approximate Self-Pay Costs
Office visit: $95-$150. Celiac panel: $80-$150. Upper endoscopy: $1,000-$2,500. GFD adherence: varies.