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The diagnosis of CD starts with suspicion from symptoms or family history. The next step is the blood tests (see next part). Then the small bowel biopsy by endoscopy. At the moment, a definitive diagnosis of CD cannot be made without the demonstration of small bowel damage (villous atrophy). A new test called DGP (Deamidated Gliadin Peptide) might make a big difference to this. There are so many millions of people with celiac disease in the world, that it is impractical to organise an endoscopy of every single affected person.
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