Coeliac tests are backed by NICE

Persistent GI symptoms and prolonged fatigue are among signs that should alert GPs to a possible diagnosis of coeliac disease, NICE has said.

New guidelines on the recognition and assessment of coeliac disease state that patients with any symptoms suggestive of the condition should be offered serological testing.

These symptoms include: chronic or intermittent diarrhoea, failure to thrive, persistent or unexplained GI symptoms, prolonged fatigue, recurrent abdominal pain, cramping or distension, sudden or unexplained weight loss and unexplained iron-deficiency anaemia.

Patients with the following conditions should also be considered for serological testing, NICE suggests: type-1 diabetes, autoimmune thyroid disease, dermatitis herpetiformis and irritable bowel syndrome.

GPs should advise those being offered testing that a gluten-containing diet must be followed before testing and a diagnosis needs to be confirmed by intestinal biopsy, but that delayed diagnosis can result in continuing ill health and long-term complications.

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