Diagnosis

The symptoms of Coeliac Disease can be severe, minor, atypical, clinically silent or closely mimic other conditions. Diagnosis is therefore often difficult. Correct diagnosis can only be made by confirming that the bowel lining is damaged. Trialling a gluten free diet does not provide a diagnosis of coeliac disease. Subsequent investigations whilst on a gluten free diet will render negative results (this includes both the serological testing [blood tests] and histological testing [biopsy] and may delay the diagnosis of another condition with similar symptoms). If coeliac disease is suspected, a close relative has the condition, or treatment for anaemia has been received on previous occasions, it is important to discuss the possibility of coeliac disease with a doctor. The following indicate a higher risk of coeliac disease and should prompt screening:

• A close family member with the disease – coeliac disease is gene-related
• Iron deficiency
• Anaemia
• Gastrointestinal symptoms that seem like irritable bowel syndrome e.g. flatulence, diarrhoea, abdominal pain, constipation, bloating, nausea or vomiting.
• Osteoporosis or osteopaenia
• Other auto-immune disease such as type 1 diabetes
• Unexplained weight loss
• Unexplained infertility

Coeliac blood tests may be used for initial screening (“coeliac serology and IgA”). If the results are positive, or if negative but there is still concern that coeliac disease may be present, a referral to a gastroenterologist will be necessary. The diagnosis must be confirmed by performing a gastroscopy (an endoscope is passed through the mouth into the small bowel), a procedure that allows tiny samples (biopsies) to be taken from the small bowel to reveal if gluten is causing damage. A gastroscopy is done in a hospital or day-procedure centre while the patient is sedated (most people find it very straight forward). Taking small bowel biopsies is an essential part of diagnosing coeliac disease as the blood test alone is not definitive. A second biopsy is usually performed after about twelve months on a gluten free diet to show that repair has occurred.

The difference in health and well-being experienced by coeliac sufferers once they are diagnosed and begin to manage the disease is often very positive and life-changing.

The Coeliac Society of Australia can provide support and information on the management of coeliac disease, www.coeliacsociety.com.au

Download Diagnosis Post Card

Download Coeliac Society of Australia Brochure

Please click here for Dr Jason Tye-Din’s article on diagnosis.