Guidelines for preventive activities in general practice

Metabolic

Coeliac

      1. Coeliac

Metabolic | Coeliac

The prevalence of self‐reported non‐coeliac wheat sensitivity and gluten avoidance in Australia is approximately 13.8%.1 However, the prevalence of proven coeliac disease is 1.2% in adult men and 1.9% in adult women2 (based on symptoms, the presence of anti-transglutaminase antibodies and histological features on duodenal biopsy).

Screening

Recommendation Grade How often References
Screening for coeliac disease in the general population is not recommended, because of insufficient evidence. Not recommended (strong) N/A 3
 

There is insufficient evidence for population screening. Screening for anti-transglutaminase antibodies may detect asymptomatic coeliac disease but may also cause harm associated with further investigations and overtreatment. In 2017, the US Preventive Services Task Force (USPSTF) found inadequate evidence on the accuracy of screening for coeliac disease; the potential benefits and harms of screening versus not screening or targeted versus universal screening; and the potential benefits and harms of treatment of screen-detected coeliac disease.3

There are no additional recommendations for this specific population.

Testing for coeliac disease is appropriate for:4,5

  • people with signs and symptoms, such as:
    • persistent unexplained gastrointestinal symptoms
    • delayed growth or weight loss
    • prolonged fatigue
    • persistent mouth ulcers
    • iron, vitamin B12 or folate deficiency
  • first-degree relative of a patient with coeliac disease
  • people with associated conditions, such as:
    • type 1 diabetes
    • autoimmune thyroid disease
    • irritable bowel syndrome in adults.

For further information on coeliac disease and patient information:
Coeliac Australia website

  1. Potter M, Jones M, Walker M, et al. Incidence and prevalence of self-reported non-coeliac wheat sensitivity and gluten avoidance in Australia. Med J Aust 2020;212(3):126–31. doi: 10.5694/mja2.50458.
  2. Anderson R, Henry M, Taylor R, et al. A novel serogenetic approach determines the community prevalence of celiac disease and informs improved diagnostic pathways. BMC Med 2013;11:188. doi: 10.1186/1741-7015-11-188.
  3. US Preventive Services Task Force; Bibbins-Domingo K, Grossman DC, et al. Screening for celiac disease: US Preventive Services Task Force recommendation statement. JAMA 2017:317(12):1252–57. doi: 10.1001/jama.2017.1462.
  4. Ludvigsson J, Bai J, Biagi F, et al. Diagnosis and management of adult coeliac disease: Guidelines from the British Society of Gastroenterology. Gut 2014;1;63(8):1210–28. doi: 10.1136/gutjnl-2013-306578.
  5. National Institute for Health and Care Excellence (NICE). Coeliac disease: Recognition, assessment and management. NICE, 2015 [Accessed 21 March 2023].
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