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Coeliac disease. Update 2000
1St Vincent's Hospital, Melbourne, Victoria. jeremy@brightongastro.com
Background:
Coeliac disease is increasingly recognised as a cause of nutritional disturbance in the Australian community. Diagnosis may be delayed because the presentation is highly variable.
Objective:
To outline an approach to diagnosis and management of coeliac disease.
Discussion:
Newer, more specific serological testing is helpful in screening asymptomatic individuals but endoscopic small intestinal biopsy is required for diagnostic certainty. A gluten free diet induces remission but not cure. Lifelong adherence reduces the risk of complications, including malignancy. All patients diagnosed with coeliac disease require expert dietetic assessment and counselling and all should be encouraged to join their state Coeliac Society. Excellent internet based sites now offer appropriate information for patients and their families.
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