Coeliac disease: the great imitator

John M Duggan
Med J Aust 2004; 180 (10): 524-526.


  • Coeliac disease (CD) is caused by a complex immunological response provoked by grain protein in susceptible people.

  • The majority of people with CD are symptom-free adults; the remainder are prone to a bewildering variety of signs and symptoms, ranging from infertility to type 1 diabetes.

  • Many patients with undiagnosed CD spend years seeking help for complaints such as chronic tiredness or mild abdominal symptoms.

  • In primary care, an appropriate target group to test for CD is people with anaemia (especially women), chronic tiredness, non-specific abdominal symptoms (including so-called “irritable bowel syndrome”), or a family history of CD.

  • The response to an appropriate gluten-free diet is often life-transforming for symptomatic patients.

  • Positive serological tests for CD require confirmation by duodenal biopsy and, if confirmed, referral to a dietitian and a coeliac society, followed by a life-long gluten-free diet.

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  • John M Duggan

  • Princeton Medical Centre, Hamilton, NSW.


Competing interests:

None identified.

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