Presentations of coeliac disease

Coeliac disease can present at any age and indeed it now more commonly presents in adulthood. Symptoms may be classic or masked and associated with non GI manifestations.

NICE suggest serological testing in people with:-

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  • persistent unexplained abdominal or gastrointestinal symptoms
  • faltering growth
  • prolonged fatigue
  • unexpected weight loss
  • severe or persistent mouth ulcers
  • unexplained iron, vitamin B12 or folate deficiency
  • type 1 diabetes, at diagnosis
  • autoimmune thyroid disease, at diagnosis
  • irritable bowel syndrome (in adults)
  • first‑degree relatives of people with coeliac disease

There is also an association with sub fertility (up to 8% may have coeliac). Treatment of the coeliac disease can improve fertility outcomes.

NICE furthermore suggests consideration of testing of people with:-

  • metabolic bone disorder (reduced bone mineral density or osteomalacia)
  • unexplained neurological symptoms (particularly peripheral neuropathy or ataxia)
  • unexplained subfertility or recurrent miscarriage
  • persistently raised liver enzymes with unknown cause
  • dental enamel defects
  • Down's syndrome
  • Turner syndrome.



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