Interpreting tests for coeliac disease: Tips, pitfalls and updates

Coeliac disease is one of most prevalent autoimmune illnesses encountered in general practice, and general practitioners have a central role in its diagnosis and follow-up. Key challenges are improving its poor rate of detection, distinguishing it from 'gluten sensitivity', and monitoring and optimising treatment to enhance long‑term outcomes.

The objective of this article is to review the evidence-based use of serology, histology and genetic testing in the diagnosis and follow-up care of adults and children with coeliac disease.

Recognition and testing of at-risk patients are keys to expediting the diagnosis of coeliac disease. Knowing when and how to use serology, histology, human leukocyte antigen typing and gluten challenge will increase the accuracy of both diagnosis and disease monitoring.