Getting Diagnosed: How to Check for Coeliac Disease
Coeliac disease — also spelled celiac disease in the US — is the same medical condition. The only difference is spelling: “coeliac” is the British English version, while “celiac” is the American. Both refer to an autoimmune disorder where the body attacks the small intestine after eating gluten.
If you think you might have coeliac disease, it’s important to get the right diagnosis. Here’s what you need to know and the steps you should take
What Is Coeliac Disease?
Coeliac disease causes your immune system to react abnormally to gluten — a protein found in wheat, barley, and rye. This reaction damages the lining of your small intestine and makes it harder to absorb nutrients properly.
Common symptoms include:
- Bloating, wind, or abdominal discomfort
- Ongoing diarrhoea or constipation
- Tiredness and low energy (even after sleep)
- Unexplained weight loss
- Brain fog or difficulty concentrating
- Skin rashes (especially dermatitis herpetiformis)
- Anaemia or vitamin deficiencies
- Delayed growth or puberty (in children)
When Should You See Your GP?
You should speak to your GP about testing if:
- You regularly experience digestive problems
- A close family member has coeliac disease
- You have an autoimmune condition like Type 1 diabetes or thyroid disease
- You’re low in iron, B12, or folate and there’s no clear reason why
- You’ve had repeated miscarriages or issues with fertility
How Coeliac Disease Is Diagnosed in the UK
1. Speak to Your GP
Your GP will go over your symptoms and may order a blood test to look for specific antibodies (usually tTG-IgA and EMA).
Blood Tests
- You need to be eating gluten regularly for the results to be reliable.
- A positive test suggests coeliac disease but doesn’t confirm it on its own.
3. Referral for Endoscopy
If your blood tests are positive (or strongly suggestive), you’ll be referred for an endoscopy with a biopsy:
- A thin tube with a camera is passed through the mouth to the small intestine.
- Tiny samples (biopsies) are taken to check for damage to the gut lining.
4. Confirmed Diagnosis
Coeliac disease is confirmed when the biopsy shows damage typical of the condition. In some children, a diagnosis can be made based on blood tests alone if levels are very high.
What If You’ve Already Gone Gluten-Free?
Many people start cutting out gluten before seeing a doctor, but this can make diagnosis difficult. If this applies to you, your GP might suggest:
-
A gluten challenge (eating gluten again daily for 6–8 weeks)
- Genetic testing for the HLA-DQ2 or DQ8 genes – if you don’t carry these, coeliac disease is very unlikely
Why a Proper Diagnosis Matters
Getting officially diagnosed has long-term benefits:
Access to NHS dietetic support and monitoring
Clear understanding of your long-term health risks
Eligibility for gluten-free food on prescription in some parts of the UK
Easier to advocate for yourself at restaurants, schools, or work