Symptoms and diagnosis of coeliac disease
The symptoms associated with coeliac disease can vary from person to person. They may be gut-related, for example:
- Abdominal pain
However, the symptoms of coeliac disease are often more general and felt outside of the gut, for example:
- Extreme tiredness
- Joint pain
The symptoms of coeliac disease can be so varied that it may take a long time for a correct diagnosis to be made. Symptoms often mimic those of other common complaints, such as irritable bowel syndrome (IBS). Your doctor should test you for coeliac disease before making a diagnosis of IBS.
Some people with coeliac disease experience no symptoms at all, however gluten will still be causing damage within the body. If left untreated, long-term complications may develop, including: osteoporosis, anaemias, fertility issues and, in rare cases, some forms of cancer.
The first stage of testing for coeliac disease involves a blood test that looks for coeliac antibodies. This test can usually be performed in your GP surgery.
If your blood test is positive, you will be referred to a gut specialist (gastroenterologist) at your local hospital who will perform a procedure called an ‘endoscopy’. This allows the doctor to examine the health of your small bowel. During the endoscopy, a small sample of cells from your gut will be taken for closer examination, this is called a small bowel biopsy.
If your endoscopy and biopsy show signs of the type of gut damage associated with coeliac disease, you will be given a formal diagnosis of the condition. However, as a result of the Covid-19 pandemic, a change to the guidance for diagnosis means that for some adults with very high antibody levels, a diagnosis can be made with a further blood test and without the need for a biopsy.
IMPORTANT: It is essential that you continue to eat a normal gluten-containing diet throughout the diagnostic process, otherwise the results of any coeliac tests may be falsely negative. Do not start a gluten-free diet until your diagnosis has been confirmed by a specialist. It is recommended that you consume gluten in at least one meal per day for 6 weeks prior to undergoing these tests.