Are follow-up check-ups necessary with coeliac disease?

Are follow-up check-ups necessary with coeliac disease?

After 1-2 years of a gluten-free diet no further invasive check-ups are necessary.

Follow-up check-ups are recommended in order to avoid the appearance of deficiencies or complications or in order to check the diet-compliance (this indicates how well the affected person is sticking to the diet plan). In principle follow-up examinations are recommended 3 months and 1 year after the diagnosis. After that, the following examinations are recommended once a year (life-long):

  • Clinical examination: weight, height, BMI, with children puberty status, general wellbeing
  • Laboratory examinations: antibody analysis in the blood and if appropriate further examinations depending on the symptoms
  • Nutrition counselling 

Biopsy check-ups are recommended if there is an uncomplicated development and when the diagnosis was given after the age of three.

If there are no doubts regarding the diagnosis then we consider it unreasonable to do a further biopsy of the small intestine in order to see whether the mucous membrane has normalised itself. We do, however, recommend regular medical examinations to check some laboratory values, especially the following:

  • Iron levels (blood count, iron, Ferritin). A persistent lack of iron can be compensated with oral iron supplements
  • Anti–tTG antibodies (a positive results indicates that the gluten-free diet was not followed strictly enough).
  • Examinations for the early detection of existing or possible autoimmune illnesses.

The check-up for osteoporosis through a bone density measurement is especially necessary for females who received a late diagnosis of coeliac disease. Should a noticeable weight gain be asserted during check-ups we recommend to do first degree metabolic examinations (total cholesterol, HDL cholesterol, triglycerides, glucose). For close relatives of people with coeliac disease (children, brothers/sisters, parents) a predisposition towards coeliac disease is higher (about 10 %) than for the general population. It is recommended therefore that immediate relatives do a serological analysis or submit to a HLA-DQ2 and HLA-DQ8 genotyping. The genotype tells whether the examined person possesses a genetic predisposition towards coeliac disease or not.