What Kind of Doctor Treats Celiac Disease or Gluten Sensitivity?

Male patient and doctor in discussion in exam room
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Many different types of doctors potentially play a variety of different roles in diagnosing and treating you for celiac disease or for non-celiac gluten sensitivity.

That's why discussing the celiac disease symptoms and/or gluten sensitivity symptoms you have with your primary care physician is a good first step to take. 

It's nearly impossible to tell the difference between the conditions from your symptoms alone, so your doctor can order the tests you'll need to determine if you have celiac disease, and can help you decide the next steps in your care.

Celiac Blood Testing Comes First

If you think you're reacting to gluten in your diet, you should determine whether or not you have celiac disease. To do this, you need to have a set of celiac blood tests. Your primary care doctor can order these tests.

You need to be eating gluten for the tests to be accurate, so don't change your diet just yet. (For more on that, see: Why do I need to eat gluten for celiac disease testing?)

If you have a positive result on these blood tests, it doesn't mean you definitely have celiac disease. However, it does mean your doctor likely will refer you to a gastroenterologist — a type of doctor who specializes in conditions involving the digestive system.

Gastroenterologists Diagnose, Treat Celiac Disease

A gastroenterologist can perform an endoscopy, a procedure that's the next step in the diagnostic process for celiac disease. In an endoscopy, the gastroenterologist will use an instrument called an endoscope to take tiny samples of your small intestine.

As the final step to diagnose celiac disease, a doctor called a pathologist — a type of physician who examines tissues — will review those samples of your small intestine to look for signs of villous atrophy, or the type of intestinal damage found in celiac disease.

If you ultimately are diagnosed with celiac disease, either your gastroenterologist or your primary care doctor (or possibly both) can provide follow-up care.

Of course, other conditions potentially can have symptoms similar to those of celiac disease. Your gastroenterologist can help you sort out the cause of those symptoms regardless of whether she ultimately diagnoses you with celiac — even if your blood tests come back negative.

Gluten Sensitivity Treated by Primary Care Physician or Gastroenterologist

If you don't test positive for celiac disease on either the blood tests or the endoscopy, you almost certainly don't have celiac disease. However, negative results on these tests don't necessarily mean you don't have a problem with gluten — you may have non-celiac gluten sensitivity instead.

Non-celiac gluten sensitivity means just what it sounds: you don't have celiac disease (because the testing was negative), but you still react to gluten (as evidenced by the fact that you feel better when you eat gluten-free, and you feel worse when you add gluten-containing foods back into your diet).

Gluten sensitivity can be treated either by your primary care physician or by a gastroenterologist.

Unfortunately, right now there are no tests universally accepted to determine if someone has gluten sensitivity, although there are a few options you might want to discuss with your doctor (for more on this, see: Gluten Sensitivity Tests). In most cases, people determine they have gluten sensitivity by cutting out gluten and then reintroducing it while watching for a reaction.

If you and your physician determine you have gluten sensitivity, you'll likely stick with that doctor for follow-up care. She can make any referrals to additional specialists that may be needed.

Other Medical Specialties Potentially Treating Gluten Issues

Regardless of whether you have celiac disease or gluten sensitivity, you may wind up needing care from different types of medical specialists.

For example, you may need to check out symptoms such as migraine (potentially investigated by a neurologist), eczema or dermatitis herpetiformis (usually treated by a dermatologist) or infertility or diabetes (generally treated by an endocrinologist).

These conditions seem to be common in people with celiac disease and gluten sensitivity, and may be better treated by a physician who specializes in those specific areas.

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