Improving the detection of coeliac disease

Area of Science:

• Gastroenterology
• Immunology
• Internal Medicine

Background:

• Coeliac disease presentation has evolved from childhood malabsorption to diverse adult symptoms like IBS, anemia, fatigue, and osteoporosis.
• Accurate diagnosis in adults relies on a combination of serological tests and duodenal biopsy.
• The shift necessitates updated diagnostic and management strategies for coeliac disease.

Purpose of the Study:

• To outline the current diagnostic pathway for coeliac disease in adults.
• To emphasize the importance of specific investigations and dietary adherence.
• To provide guidance on the management and follow-up of adult coeliac disease patients.

Main Methods:

• First-line screening involves IgA-tissue transglutaminase antibody testing.
• A gluten-containing diet for six weeks prior to testing is crucial for accurate results.
• Confirmatory diagnosis requires a mandatory duodenal biopsy.

Main Results:

• IgA-tissue transglutaminase antibody testing is the recommended initial screening method.
• Maintaining a gluten-containing diet before investigation ensures reliable serological and histological findings.
• Duodenal biopsy is essential for definitive coeliac disease diagnosis.

Conclusions:

• Adult coeliac disease diagnosis requires a dual approach: serology and biopsy.
• Lifelong adherence to a strict gluten-free diet is the cornerstone of coeliac disease management.
• Specialist dietitian support and annual follow-up are vital for stable disease management.