Recent developments in our understanding of adult coeliac disease

Coeliac disease, previously regarded as unusual and florid, is now seen as having an extraordinary breadth of manifestations. Many cases are unrecognised or latent. Diarrhoea and abdominal complaints may be present in low key but chronic ill health; anaemia, endocrine and neurological changes are increasingly recognised. Suspicion should lead straight to serological tests, of which the antiendomysial antibody test is best. If suspicion is high, endoscopic duodenal biopsy is mandatory. A gluten free diet, while difficult to maintain, effectively cures and prevents complications.