Coeliac Disease

1% UK population 3% Pts presenting with “IBS” symptoms Minimal/atypical symps 2:1 female – male Smoking protective

Coeliac Serology

Antigliadin Ab Assays – obsolete IgA Endomyseal Ab (EMA) IgA TTG Ab – beware IgA deficiency

Highly sensitive & specific

Good screening test for Coeliac Disease

Diagnosis

Serology +/Histology+Coeliac Disease

Serology +/Histology - Review/repeat bx 1yr

Serology-/Histology+ Consider other causes enteritis.If none treat as Coeliac

Serology-/Histology- Diagnosis excluded

Management

GFD – most can eat oats Screen for and manage osteoporosis Persistent symps – check diet, think of other

things Refractory Coeliac – low-grade lymphoma