Upset tummies happen to everyone, but when your gastrointestinal distress is ongoing, you will need to look farther than the pharmacy’s antacid aisle for some relief.

Chronic symptoms such as diarrhea, gas, abdominal pain and bloating can be caused by many things, including celiac disease. Celiac also can cause fatigue and brain fog. It’s a genetic autoimmune disease in which ingestion of gluten, a protein found in wheat, rye and barley, leads to damage in the small intestine.

The only treatment for celiac is a completely gluten-free diet. Although it may seem like a good idea to give that a try if you have ongoing stomach issues, it’s important to see a doctor first and have a true diagnosis. 

“A lot of people self-diagnose (celiac), which we would highly recommend against,” says J. Carter Balart, MD, a gastroenterologist at The Baton Rouge Clinic. “If you think you have celiac, you definitely want to get tested.” The diagnostic process begins with a simple blood test, and if positive, your doctor would perform an upper endoscopy to confirm.

Dr. Balart says it’s not uncommon for other gastrointestinal problems to respond to a gluten-free diet. “You may feel better if you’re just eating better food,” he says. But eating gluten-free before being tested for celiac can make the test inaccurate. Eating gluten-free is also much more expensive, and it’s important to know if you really have celiac to address long-term issues.

Without treatment, celiac can lead to serious complications such as anemia, osteoporosis, and higher risks of developing heart disease and intestinal cancer. The Celiac Foundation estimates that as many as one in every 100 people worldwide have celiac, and 2.5 million Americans are undiagnosed.

Eating a truly gluten-free diet is difficult even in our society that advertises gluten-free food at every other restaurant. Dr. Balart recommends exercising caution and avoid a false sense of security. “If a gluten-free crust is prepared on the same surface as regular dough, that’s all it takes to get some gluten exposure,” he says. “If you have celiac and are eating out, be very careful of exposure to gluten.”

Although there’s no way to avoid developing celiac, if you suspect that you might have it, Dr. Balart says the best thing to do is see your doctor.