Medically reviewed by Dr Usman Naeem, 24 Oct 2026.
Key points
- Test while still eating gluten; do not stop it before testing.
- The first test is a blood test (tTG-IgA with total IgA); adults usually need small-bowel biopsies to confirm.
- Treatment is a strict, lifelong gluten-free diet, ideally with dietitian support.
- First-degree relatives may be advised to be tested.
Overview
In coeliac disease, gluten triggers the immune system to damage the finger-like projections (villi) that absorb nutrients. This can lead to diarrhoea, weight loss, anaemia and deficiencies, but some people have few gut symptoms.
It is more common than many people think, and is more frequent in people with type 1 diabetes, thyroid disease and a family history.
Causes and risk factors
- Genetic susceptibility (HLA-DQ2 or DQ8) combined with gluten exposure
- A close relative with coeliac disease
- Type 1 diabetes, autoimmune thyroid disease
Symptoms
- Diarrhoea, bloating, or fatty, foul-smelling stools
- Weight loss or poor growth in children
- Iron-deficiency anaemia that does not settle, mouth ulcers, tiredness
- Itchy blistering skin rash (dermatitis herpetiformis) in some
When to seek urgent medical care
- Persistent diarrhoea with weight loss
- Unexplained anaemia or low vitamin and mineral levels
In an emergency go to the nearest emergency department or call Rescue 1122.
How it is assessed
- Blood test: tTG-IgA with total IgA, done while eating gluten
- Confirmation in adults usually with small-bowel biopsies taken during upper endoscopy
Treatment
Treatment
- A strict, lifelong gluten-free diet, ideally with dietitian support
- Checks for vitamin and mineral deficiencies and bone health
- Screening of close family members may be advised
What you can do
Common questions
Should I stop gluten to see if I feel better?
Please do not stop before testing. Stopping gluten can make tests falsely normal and delay a clear diagnosis.
اردو خلاصہ
سیلیک بیماری میں گلوٹین (گندم، جو اور رائی میں پایا جاتا ہے) سے مدافعتی ردعمل چھوٹی آنت کی اندرونی تہہ کو نقصان پہنچاتا ہے۔ علامات میں دست، پیٹ پھولنا، وزن میں کمی اور خون کی کمی شامل ہیں۔ ٹیسٹ کروانے سے پہلے گلوٹین بند نہ کریں؛ علاج عمر بھر گلوٹین فری غذا ہے۔
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This page gives general information prepared for Dr Usman Naeem and is not personal medical advice. See the medical disclaimer.