Coeliac disease: where are we in 2014?

Background: Coeliac disease (CD) is an autoimmune condition affecting at least 1% of the population, many of whom remain undiagnosed. It is characterised by chronic inflammation of the small-intestinal mucosa and triggered by eating gluten. It is challenging to diagnose be-cause of the many and varied ways in which it may present.

Objective: To present up-to-date information on CD as we now understand it, with recommendations on whom to test and how to test them, and how to manage patients once they are diagnosed.

Discussion: Primary care practitioners have a crucial role in improving rates of CD diagnosis, and in the ongoing care of patients with CD. A blood test for coeliac-specific antibodies will identify most patients who need to undergo duodenal biopsy to make the diagnosis. Management encompasses supporting patients with adherence to the gluten-free diet and conducting a CD-focused clinical review every 1-2 years.