How Do You Manage Coeliac Disease After Diagnostic Confirmation?

So, you’ve received a positive result on your tissue transglutaminase (tTG) IgA blood test for coeliac disease. Your HCP told you that it’s very likely that you have coeliac disease.

You may feel relieved to finally understand the likely cause of your symptoms, or you may be anxious about what will happen next. Read on to understand what this positive blood test means for you, and how you can continue your journey towards a healthier and happier life.

Confirming the diagnosis of coeliac disease

Although a positive tTG IgA blood test means it’s very likely that you have coeliac disease, you shouldn’t remove gluten from your diet until advised to do so by a healthcare professional. This is because further investigations may be needed to confirm the diagnosis, and these tests will only work if you’re still eating gluten.1-3

Your GP may arrange further tests in primary care, and will refer you to a gastroenterologist.1-3 Gastroenterologists are experts in disorders of the gut, including coeliac disease, and will be able to arrange specialist tests.

I’ve been diagnosed with coeliac disease. What next?

If your diagnosis is confirmed as coeliac disease, your GP or gastroenterologist should:1,3

  • Check your physical health, including height and weight
  • Order routine blood tests (complete blood count, iron, folate, vitamin B12, thyroid function, etc)
  • Refer you to a dietitian who specialises in gluten-free diets. Learn more >
  • Arrange scans to check your bone health, especially if you’re at risk of bone disease
  • Arrange regular follow-up appointments to check your health in the future 

There are also coeliac disease societies and support groups, which can help people who need to live without gluten. Your doctor may direct you to relevant groups local to you.1

Coeliac disease runs in families. Because of this, speak with your family members so they too can learn about coeliac disease and consult their doctors about getting tested.1,3

How can a dietitian help me live gluten-free?

Avoiding gluten-containing foods can resolve your symptoms and help you live a healthier and happier life.1,3 However, a strict gluten-free diet can be hard to achieve, as gluten is found in a surprisingly wide range of foods.4 Eating even a small amount of gluten could result in relapse of your symptoms.1

Therefore, your doctor should always refer you to a dietitian for expert advice.1,3 A dietitian can:

  • Assess your nutritional status
  • Educate you on how to maintain a healthy gluten-free diet
  • Adjust your diet to meet your individual needs
  • Answer any questions you may have about your diet

1. Al-Toma A, Volta U et al. European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European Gastroenterol J 2019;7(5):583-613

2. Husby S, Koletzko S et al. European Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for diagnosing coeliac disease 2020. J Pediatr Gastroenterol Nutr 2020;70(1):141-156

3. Rubio-Tapia A, Hill I D et al. ACG clinical guidelines: diagnosis and management of celiac disease. Am J Gastroenterol 2013;108(5):656-676;quiz 677

4. Biesiekierski J R. What is gluten? J Gastroenterol Hepatol 2017;32(S1):78-81