In Europe 1 in 250 people are diagnosed with celiac disease ( gluten intolerance). It is diagnosed less commonly in the United States, largely because many physicians fail to recognize the symptoms. The average time between the onset of symptom and diagnosis is 11 year. We need to do better.

What are some of the symptoms:
1. Abdominal pain
2. Diarrhea
3. Weight loss
4. Headaches
5. Hair loss
6. Fatigue
7. Psychiatric symptoms
8. Bone and muscle pain
(Frequently, the disease appears in monosymptomatic form with uncharacteristic symptoms.)   The average time between the onset of symptom and diagnosis is 11 year. We need to do better.

How is it diagnosed?
A. A 3 week trial off all gluten containing foods
B  A blood test may be helpful

There are three blood tests available for the diagnosis.
All are reliable.
1. IgA ELISA anti- gliadin
2. IgA IFA (indirect immunofluorescence) anti-endomysium
3. IgA ELISA anti-endomysium
The last two tests (anti-endomysium) show a better sensitivity and specificity than the 1st (anti-gliadin). The first test is the most available currently and probably the least expensive. The 2nd test is more difficult to perform and most expensive. The third test is as reliable as the 2nd and as easy to perform as the first but it is new and not yet widely available.

Treatment:
A gluten free diet.