About this condition
Coeliac disease is an immune-mediated disorder in which gluten triggers injury to the lining of the small intestine. It may cause bloating, abdominal pain, diarrhoea, constipation, weight loss, iron deficiency or other nutrient problems. Some people have few digestive symptoms.
Clinical features
Coeliac disease is not the same as wheat allergy or any bloating after eating bread. A normal routine blood count does not rule it out. Starting a gluten-free diet before assessment can lower antibody levels and make tests falsely negative.
Important differences and warning signs
A clinician reviews your history, family risk and signs of deficiencies, and may recommend coeliac blood tests or, when appropriate, gastroscopy with small-bowel biopsies. Tell your clinician if you have already stopped eating gluten. Do not reintroduce it after prolonged avoidance without discussing a diagnostic plan.
Assessment and individual care
Once the diagnosis is confirmed, treatment is a strict lifelong gluten-free diet, education on hidden gluten and follow-up of nutritional status. Restrictive diets based only on unvalidated food-intolerance tests are not a substitute for appropriate diagnosis.
Related information: Irritable bowel syndrome; Persistent diarrhoea.
Signs and symptoms
- Bloating, persistent diarrhoea or constipation and recurring abdominal discomfort.
- Unexplained weight loss, fatigue, iron-deficiency anaemia or other nutritional deficits.
- Some people have extra-intestinal symptoms with little obvious digestive disturbance.
Diagnosis and tests
Assessment usually uses appropriate antibody tests while gluten is still being eaten. The need for biopsy or an alternative strategy after gluten avoidance should be decided with a clinician.
Care and treatment approaches
For confirmed coeliac disease, a lifelong gluten-free diet and nutritional follow-up are essential. Avoid starting major dietary restrictions before testing unless medically advised.
When to seek urgent care
Severe dehydration, gastrointestinal bleeding, sudden severe abdominal pain or profound nutritional deterioration needs urgent care. For serious symptoms call 103.
Frequently asked questions
Should I stop eating gluten before blood tests?
No. Removing gluten can lead to falsely negative tests. Discuss the testing pathway first.
Does coeliac disease always cause diarrhoea?
No. Constipation, anaemia, nutrient deficiencies or few digestive symptoms may be the main features.
Are coeliac disease and wheat allergy identical?
No. They are different disorders with distinct mechanisms, investigations and dietary advice.
Information sources
Medical source links used when preparing this article.
Important information
A medical consultation is needed for diagnosis and treatment recommendations.
Self-treatment can be harmful to your health.
