Gastroenterology Pearland, Houston, Bay City, Lake Jackson
Conditions
Celiac disease is an autoimmune disorder in which consuming gluten—a protein found in wheat, barley, and rye—triggers an immune response that damages the small intestine. This damage impairs nutrient absorption and can lead to a wide range of gastrointestinal and systemic symptoms. At Your GI Center, our board certified gastroenterologists provide comprehensive diagnosis and management of celiac disease at three convenient Southeast Texas locations in Houston, Bay City, and Lake Jackson. With over 25 years of experience in digestive health care, we help patients navigate the challenges of celiac disease and achieve symptom relief through proper diagnosis and dietary management.
Celiac disease affects approximately 1% of the population in the United States, though many cases remain undiagnosed. The condition can develop at any age, from early childhood through adulthood. Left untreated, celiac disease can cause serious long-term complications including malnutrition, osteoporosis, infertility, neurological problems, and increased risk of certain cancers. Fortunately, celiac disease is manageable through strict adherence to a gluten-free diet, which allows intestinal healing and resolution of symptoms in most patients.
In celiac disease, the immune system mistakenly identifies gluten as a threat and mounts an inflammatory response. This inflammation primarily affects the small intestine, specifically damaging the villi—tiny, finger-like projections lining the small intestine that absorb nutrients. As villi become flattened and damaged, the surface area available for nutrient absorption decreases dramatically, leading to malabsorption of vitamins, minerals, and other essential nutrients.
Celiac disease has a strong genetic component. The condition occurs almost exclusively in individuals carrying specific genetic markers (HLA-DQ2 or HLA DQ8). However, genetics alone do not cause celiac disease; environmental factors including the timing and amount of gluten introduction in infancy, gastrointestinal infections, and other unknown triggers also play roles. Having a first-degree relative with celiac disease increases risk substantially, with approximately 10% of first-degree relatives also having the condition.
Celiac disease is distinct from non-celiac gluten sensitivity and wheat allergy. Non-celiac gluten sensitivity causes symptoms similar to celiac disease when gluten is consumed, but without the autoimmune response or intestinal damage.
Wheat allergy is an allergic reaction to wheat proteins that can cause symptoms ranging from hives to anaphylaxis. Only celiac disease involves autoimmune mediated intestinal damage and requires lifelong strict gluten avoidance.
The location of abdominal pain often provides clues about its source:
Celiac disease symptoms vary widely among individuals, ranging from severe gastrointestinal distress to subtle or absent symptoms. Classic gastrointestinal symptoms include chronic diarrhea or constipation, abdominal pain and bloating, gas and flatulence, nausea and vomiting, and fatty, foul-smelling stools (steatorrhea) resulting from fat malabsorption.
Many patients experience primarily non-gastrointestinal symptoms, which can delay diagnosis. These include unexplained iron-deficiency anemia that does not respond to iron supplementation, fatigue and weakness, bone or joint pain, osteoporosis or osteopenia from calcium and vitamin D malabsorption, recurrent mouth ulcers (aphthous stomatitis), an itchy, blistering skin rash called dermatitis herpetiformis, headaches and migraines, numbness or tingling in hands and feet (peripheral neuropathy), and cognitive difficulties including “brain fog.”
Children with celiac disease may experience failure to thrive, delayed growth and puberty, short stature, chronic diarrhea, vomiting, abdominal distension, irritability and behavioral problems, and dental enamel defects.
Celiac disease is associated with several other autoimmune and medical conditions. Type 1 diabetes occurs with increased frequency in celiac patients, and screening for celiac disease is recommended in diabetic individuals. Autoimmune thyroid disease (Hashimoto’s thyroiditis or Graves’ disease) is more common in celiac patients. Down syndrome, Turner syndrome, and Williams syndrome are associated with higher celiac disease prevalence. Selective IgA deficiency, an immune deficiency, occurs more frequently and can affect celiac disease testing. Infertility and recurrent miscarriage have been linked to undiagnosed celiac disease.
Accurate diagnosis of celiac disease requires a systematic approach combining blood tests and, in most cases, intestinal biopsy. Critically, testing must be performed while the patient is consuming a gluten-containing diet, as gluten avoidance causes antibody levels to normalize and intestinal damage to heal, potentially leading to false-negative results.
At Your GI Center’s Houston, Bay City, and Lake Jackson locations, celiac disease evaluation begins with serologic (blood) testing. Tissue transglutaminase antibody (tTG-IgA) is the most sensitive and specific screening test for celiac disease. Total IgA level is measured simultaneously, as IgA deficiency can cause false-negative tTG-IgA results. If IgA deficiency is present, IgG-based tests are used instead. Endomysial antibody (EMA-IgA) is highly specific for celiac disease and may be used as a confirmatory test. Deamidated gliadin peptide antibodies (DGP) may be checked in certain situations.
Genetic testing for HLA-DQ2 and HLA-DQ8 does not diagnose celiac disease but can help rule it out. The absence of these genetic markers makes celiac disease extremely unlikely. Genetic testing is useful when patients have already started a gluten-free diet before testing or when diagnosis is uncertain.
Upper endoscopy with small bowel biopsy remains the gold standard for confirming celiac disease diagnosis. During this procedure, multiple small tissue samples are obtained from the duodenum (the first part of the small intestine) and examined microscopically for characteristic changes including villous atrophy, crypt hyperplasia, and increased intraepithelial lymphocytes. The degree of damage is graded using the Marsh classification system.
In select cases, particularly in children with very high antibody levels and characteristic symptoms, diagnosis may be made without biopsy, though this approach is not standard in adults
Many abdominal pain cases have gastrointestinal origins:
Stomach acid backing up into the esophagus causes burning pain in the upper abdomen and chest. Pain often worsens after meals or when lying down.
The gluten-free diet requires significant lifestyle changes and education. Naturally gluten-free foods including fruits, vegetables, meat, poultry, fish, eggs, most dairy products, beans and legumes, nuts and seeds, and gluten-free grains (rice, corn, quinoa, buckwheat, millet) form the foundation of the diet. Many processed foods contain hidden gluten in additives, flavorings, or cross-contamination during manufacturing, requiring careful label reading. Dedicated gluten-free products including bread, pasta, and baked goods are widely available but can be expensive. Cross-contamination must be avoided by using separate cooking utensils, toasters, and cutting boards, and being cautious when dining out.
Working with a registered dietitian experienced in celiac disease is highly beneficial for learning to navigate the gluten-free diet, ensuring nutritional adequacy, and addressing common deficiencies.
Nutritional supplementation may be necessary, particularly in the first months after diagnosis. Common deficiencies include iron, calcium and vitamin D, vitamin B12, folate, and zinc. These are corrected through supplementation while the intestine heals.
Follow-up care is essential. Repeat serologic testing 3-6 months after starting a gluten-free diet confirms that antibody levels are decreasing, indicating dietary adherence and intestinal healing. Annual follow-up with your gastroenterologist monitors symptoms, assesses dietary adherence, screens for nutritional deficiencies, and evaluates for associated conditions. Repeat endoscopy may be performed if symptoms persist despite a gluten-free diet or if initial damage was severe.
Why Choose
Diagnosing and managing celiac disease requires expertise in recognizing the diverse presentations of this condition and commitment to long-term patient support. At Your GI Center, our board-certified gastroenterologists have extensive experience with celiac disease and understand the challenges patients face adapting to a gluten-free lifestyle.
We provide comprehensive celiac disease care including thorough diagnostic evaluation with appropriate testing, upper endoscopy with small bowel biopsy when indicated, nutritional counseling and referral to experienced dietitians, ongoing monitoring and support, and screening of family members when appropriate.
With offices in Houston, Bay City, and Lake Jackson, we provide convenient access to specialized celiac disease care throughout Southeast Texas. We accept most major insurance plans and work to make care accessible to all who need it.
If you are experiencing symptoms suggestive of celiac disease, have a family history of the condition, or have associated autoimmune disorders, contact Your GI Center today to schedule a consultation with one of our board-certified gastroenterologists.
To schedule your appointment, call 1-888-292-0010 or contact your preferred location: