How to diagnose Coeliac Disease?

Almost 1 in 100 Australians are affected by coeliac disease. However, 160,000 Australians have not been correctly diagnosed. If left untreated or misdiagnosed Coeliac Disease can lead to osteoporosis, iron deficiency, infertility, depression, liver disease, miscarriages, some cancers and autoimmune diseases.

Coeliac Disease can affect people in various ways with some experiencing more severe symptoms than others. Patients who have coeliac disease commonly experience weight loss, anaemia, diarrhoea, constipation, bloating, abdominal pain and lethargy. 

How to diagnose Coeliac Disease?
To correctly diagnose Coeliac Disease it is important for the patient to go through the following steps

1. Prior to testing - Keep eating gluten

If a patient has not consumed gluten for some time it is important to have them complete a ‘gluten challenge” 6 weeks prior to being tested. The gluten challenge must include four slices of wheat based bread or an equivalent food each day.

1. Screen for Coeliac Disease with appropriate blood tests

A coeliac serology blood test measures the antibody levels in an individual who has untreated coeliac disease. i.e. they must completed the gluten challenge and be still consuming gluten at the time of the blood test.

Blood tests are not always accurate and therefore should never be used as a definitive diagnosis for the disease. If the serology is positive, the patient MUST continue consuming gluten and have a small bowel biopsy to confirm the diagnosis. The serology is just a screening test! 

1. A small bowel biopsy is essential

The patient must continue to consume the equivalent of 4 slices of gluten containing bread until the small bowel biopsy has been completed.

1. Gene testing (HLA genes)

Gene testing can be used when the diagnosis of coeliac disease is not conclusive from the results of a blood test or bowel biopsy. This can be caused by the patient not consuming any or the correct amount of gluten for a serology or bowel biopsy.  

What can a Simply Nutrition Dietitian do for a patient with coeliac disease?

• Treatment of symptoms
• Improved nutritional intake

• Improved BMI
• Improved or normal bowel habits

Further information on Coeliac Disease can be found at Coeliac Australia - www.coeliac.org.au