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University of Oklahoma Health Sciences Center

Diagnosis and management of celiac disease

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Author/s: 
Jedid-Jah Blom, Dominica Gidrewicz, Justine Turner, Donald R. Duerksen, M. Ines Pinto-Sánchez
Date Added: 
November 11, 2025
Journal/Publication: 
Canadian Medical Association Journal
Publication Date: 
November 11, 2025
Type: 
Meta-analyses, Reviews, and Guidelines
Format: 
Article
DOI (1): 
https://doi.org/10.1503/cmaj.230091

RPR Commentary

A concise review of the diagnosis and management of patients with celiac disease. James W. Mold, MD, MPH

Abstract

Celiac disease is frequently undiagnosed, in part because of its highly variable clinical presentation.

Celiac disease can present with classic gastrointestinal symptoms (e.g., diarrhea, abdominal pain, bloating, weight loss), atypical or extraintestinal manifestations (e.g., anemia, osteoporosis, neurologic symptoms, infertility, fatigue) or asymptomatic presentations detected from screening.

The first-line serologic screening test measures tissue transglutaminase immunoglobulin A and should be conducted while the patient is consuming gluten.

Complications of celiac disease include nutritional deficiencies, osteoporosis, increased risk of viral infections and pneumonia, and, rarely, risk of malignancy.

Adherence to a lifelong, strict gluten-free diet with regular monitoring of disease activity and nutritional status is key for symptom management and to prevent complications.