Typically, most people with celiac disease will have symptoms of malabsorption such as diarrhea. However, some will have bone disease, anemia, or other conditions without diarrhea. Compression fractures of the back, kyphoscoliosis (see scoliosis), or other signs of bone disease may be present. Steatorrhea ("fatty" diarrhea, or stools that can be foul smelling and unusually colored) is common.
Dental examination may show changes in the teeth. In fact, some cases of celiac disease are suspected by a dentist because of the changes in the enamel of the teeth, which include symmetrical (the same on both sides) changes in the tooth color and surface texture.
A CBC often indicates anemia. Two relatively new blood tests have improved the ability to accurately diagnose this disorder: Both the IgA antiendomysial antibody and the antigliadin antibodies are sensitive and specific for the diagnosis of celiac disease. An EGD (endoscopy) and small bowel biopsy, particularly biopsy of the jejunum (the part of the small intestine most often affected), will show an abnormal intestinal lining. Serial biopsies may be performed before and after a gluten-free diet. Improvement of the findings of biopsy (or improvement of symptoms) after a gluten- and gliadin-free diet is considered highly indicative of celiac disease.
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