Celiac Disease Diagnosis: Understanding the No-Biopsy Approach

People often ask…

**“How do you actually get diagnosed with celiac disease?”**

For most people in the United States, diagnosis still involves:

Positive celiac blood tests

A positive endoscopic biopsy

But in some children…

There may be another path.

It’s often called a **“triple positive”** or **“no-biopsy”** diagnosis.

This approach has been used in Europe for years and is now increasingly recognized in the United States for selected pediatric patients.

That typically means:

**tTG-IgA is more than 10× your lab’s normal range**

**A second blood sample confirms a positive EMA test**

**The child is still eating gluten during testing**

And yes…

**All testing must be done while eating gluten.**

No gluten…

No accurate test.

Celiac is common.

**Diagnosis is not.**