A clear guide for Valley Gastroenterology patients.
What is celiac disease?
Celiac disease is an autoimmune condition in which eating gluten (proteins in wheat, barley, and rye) triggers immune injury to the small intestine. This can lead to nutrient deficiencies and a wide range of symptoms.
Common symptoms
- Bloating, gas, abdominal pain
- Chronic diarrhea, constipation, or both
- Unintentional weight loss, fatigue
- Iron‑deficiency anemia
- Mouth ulcers, skin rash (dermatitis herpetiformis)
- In children: poor growth, delayed puberty
Red‑flags — call us promptly
- Persistent diarrhea with dehydration, black/tarry stools, vomiting blood
- Severe weight loss, fainting, or signs of anemia (shortness of breath, dizziness)
Who should be tested?
- Family history of celiac (parent, sibling, child)
- Iron‑deficiency anemia without a clear cause
- Chronic GI symptoms (diarrhea, bloating, abdominal pain)
- Unexplained elevated liver tests
- Osteopenia/osteoporosis earlier than expected
- Associated autoimmune conditions (Type 1 diabetes, autoimmune thyroid disease)
Do not start a gluten‑free diet before testing. It can normalize tests and mask the diagnosis.
How celiac is diagnosed
- Blood tests (serology) while eating gluten:
- Tissue transglutaminase IgA (tTG‑IgA) and total IgA (checks for IgA deficiency)
- If IgA deficient or in young children: DGP IgG/tTG‑IgG
- Upper endoscopy with biopsies of the small intestine to confirm and stage damage
- Genetic testing (HLA‑DQ2/DQ8) may help exclude celiac in unclear cases (absence makes celiac very unlikely)
Treatment
- Strict gluten‑free diet for life (avoid wheat, barley, rye; oats must be certified gluten‑free)
- Work with a registered dietitian for label reading, dining‑out strategies, and cross‑contamination prevention at home
- Correct nutrient deficiencies (iron, folate, vitamin B12, vitamin D, calcium) as needed
Many patients feel better within weeks, but intestinal healing can take months. Never stop the diet even when symptoms improve.
Follow‑up care
- Symptom and weight check; reinforce gluten‑free skills
- Labs: CBC, iron studies, folate, B12, vitamin D, +/- zinc; liver tests as indicated
- Serology (tTG‑IgA) to monitor response (should fall toward normal over 6–12 months)
- Bone health: consider DEXA scan at diagnosis if risk factors (e.g., fractures, postmenopausal, men >50, prolonged untreated disease)
- Screen for associated conditions (e.g., thyroid disease) as appropriate
- Vaccinations per primary care guidance (e.g., ensure routine immunizations up to date)
Living gluten‑free (quick tips)
- Safe grains: rice, corn, quinoa, buckwheat, millet, certified GF oats
- Watch hidden gluten: sauces, soups, gravies, soy sauce (choose tamari), seasonings, beer
- Prevent cross‑contact: separate toaster/cutting boards; clean cookware and surfaces
- Ask for GF menus and confirm preparation practices when dining out
When symptoms persist
- We’ll reassess for inadvertent gluten exposure, lactose intolerance, SIBO, microscopic colitis, pancreatic insufficiency, or other conditions
- Rarely, refractory celiac needs specialized evaluation
Alaska‑specific note
We offer telehealth for diet education and follow‑ups. Weather/road issues? We’ll reschedule without penalty and coordinate local lab work when possible.
Next steps
If you suspect celiac disease—or have a family history—schedule testing before changing your diet. We’ll guide you from diagnosis to long‑term nutrition support.
Valley Gastroenterology
3190 E Meridian Park Loop, Suite 206
Wasilla, Alaska 99654
Phone: (907) 373-2544
Fax: (844) 689-4240
Web: ValleyGastroAK.com
Celiac Disease — Patient Information