Coeliac disease is an under-diagnosed, under- managed condition. Coeliac disease is no longer thought of as a classical presentation of malnutrition at childhood. It can present as one of several vague symptoms or disease comorbidities at any age.1
More than 70% of patients with coeliac disease have yet to be diagnosed.10
Case-finding for coeliac disease in these high-risk populations is recommended.11-21
It is recommended that you consider serological testing for celiac disease in people with:11-21
The average time from symptom onset to correct diagnosis of coeliac disease is 13 years.22
Untreated patients are more likely to develop long-lasting complications.23
Coeliac disease is manageable, and symptoms can be resolved, by strictly adhering to a lifelong gluten-free diet.11,24-29
Adding diagnostic testing to aid in a differential diagnosis has been shown to increase confidence in diagnosis to 90 percent.i,ii Conventionally, a diagnosis of allergic or autoimmune disease relies on the case history and a physical examination. However, adding diagnostic testing to aid in a differential diagnosis has been shown to increase confidence in diagnosis.i,ii Diagnostic testing can also help to improve the patient’s quality of life and productivity, reduce costs associated with absenteeism, and optimize use of medication, in addition to decreasing unscheduled healthcare visits.iii,iv
i. Duran-Tauleria E, Vignati G, Guedan MJ, et al. The utility of specific immunoglobulin E measurements in primary care. Allergy. 2004;59 (Suppl78):35-41.
ii. NiggemannB, Nilsson M, Friedrichs F. Paediatric allergy diagnosis in primary care is improved by in vitro allergen specific IgE testing. Pediatr Allergy Immunol. 2008;19:325-331
iii. Welsh N, et al. The Benefits of Specific Immunoglobulin E Testing in the Primary Care Setting. J Am Pharm Assoc. 2006;46:627.
iv. Szeinbach SL, Williams B, Muntendam P, et al. Identification of allergic disease among users of antihistamines. J Manag Care Pharm. 2004; 10 (3): 234-238
Learn about gastrointestinal disease.
Learn more about testing.
The initial step toward a coeliac disease diagnosis is to test for coeliac-related antibodies.
Tissue transglutaminase IgA (IgA tTG) is the recommended first line test, together with total IgA to check for IgA deficiency. Most international guidelines, as well as NICE, recommend this. For this test to work, the patient must be consuming gluten.
Request testing through your local pathology lab. Your local pathology lab can advise if a specific algorithm needs to be followed based on the result and the age of the patient.
The early identification and appropriate management of patients with coeliac disease improves clinical outcomes including reducing the risk of cancer, reversing symptoms, and improving QoL*.11,24-29
It is clinically effective and cost effective to use tTG IgA and DGP IgG to determine the need for endoscopy in patients with suspected coeliac disease.11,24-29
Decrease the risk of:
Improve:
Resolve:
ACTIVELY TEST
Diagnosis and treatment of coeliac disease significantly reduces the costs of tests by 21 percent.29
CASE-FIND IN YOUR PRACTICE
Diagnosis and treatment of coeliac disease sigificantly reduces referral to secondary care by 37 percent.
CONSIDER EVALUATING
Screening and then treating for coeliac disease is cost-effective in first-degree relatives, IBS patients and type 1 diabetes patients.11