Interpreting tests for coeliac disease: Tips, pitfalls and updates

Background

Objective

Discussion

Published in AJGP (Australian Journal of General Practice published by the Royal Australian College of General Practitioners)

Electronic resources

The Coeliac Australia Medical Advisory Committee (MAC) has designed CDM (Chronic Disease Management) templates for both adults and children, incorporating GP Management Plan (GPMP) and Team Care Arrangement (TCA) documents, suitable for use with the following four medical practice computer programs.

Please refer to instructions below before commencing download

• Medical Director
• Medical Director – Children
• Best Practice
• Best Practice – Children
• Genie
• Genie – Children
• Zed Med
• Zed Med – Children
• Chronic disease management forms (including for children)

Further information from the UK

Coeliac disease (2015): recognition, assessment and management of coeliac diseaseThe NICE guideline on irritable bowel syndrome (IBS) (link below) highlights the importance of excluding coeliac disease before diagnosing IBS.

(2008) Irritable bowel syndrome in adults: diagnosis and management of irritable bowel syndrome in primary care

British Society of Gastroenterology (BSG)The BSG guidelines for the management of adults and children with coeliac disease (link below) represent a consensus of best practice based on the available evidence at the time of preparation. They may not apply in all situations and should be interpreted in the light of specific clinical situations and resource availability.

Guidelines on the diagnosis and management of adult coeliac disease (2014) Ludvigsson JF, Bai JC, Biagi F et al.

Article

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.
Published in the Australian of General Practice published by the Royal Australian College of General Practitioners.

Printed resources

Fact Sheets

• Diagnosing coeliac disease – the key facts Fact sheet – gives a summary of content provided in the video presented by Assoc. Prof. Jason Tye-Din, Diagnosing coeliac disease – A brief guide for GPs, to support the diagnosis of coeliac disease. (Video available on this site from 1 March 2016). Download diagnosing coeliac disease – the key facts

• Testing and diagnosis of coeliac disease in children Fact sheet – provides information relating to additional considerations when testing and diagnosing coeliac disease in children. Download testing and diagnosis of coeliac disease in children fact sheet

• Plain English Fact sheet gives an overview of what coeliac disease is, possible symptoms, and steps to diagnosis, in simpler language.

Brochures

• Coeliac disease – gives an overview of coeliac disease, who can develop coeliac disease, the range of symptoms, the process for diagnosis and the benefits of getting a medical diagnosis.

• Conditions associated with coeliac disease – outlines a range of other medical conditions that can be associated with coeliac disease.

Family screening and gene testing

• The family screening letter is designed to be given to close family members of those diagnosed with coeliac disease, so they can take it to their own GP to request screening for coeliac disease. The letter provides the GP with information regarding testing and correct diagnosis.

• The coeliac disease gene test – analysis and reporting letter provides information for health professionals regarding reported discrepancies in genetic testing results for coeliac disease, as well as evidence-based guidance for clinically appropriate use of HLA typing and a reporting template for pathology providers to improve communication of results. Download coeliac disease gene test – analysis and reporting

Other

• Referral cards – can be used by health professionals to refer clients to Coeliac Australia. (Currently only available in electronic format for download).

• Diagnostic postcard – designed for health professionals, this card provides a flowchart of the steps involved in the diagnosis of coeliac disease, including specific test names. (Currently only available in electronic format for download).

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