Coeliac disease is an illness in which there is a permanent intestinal intolerance of gluten. Gluten is a protein found in wheat and other cereals, which is present in a lot of foods including bread and pasta.  Coeliac disease is common, occurring in about 1 in 100 people.  Symptoms include diarrhoea (loose poo), poor growth or stomach bloating. A proportion of people with coeliac disease have mild or no symptoms. This diagnosis is a common reason for referral.  The diagnosis may sometimes be made on the basis of blood tests, but a number of children require an intestinal biopsy to confirm the diagnosis.  This needs to be performed before any dietary change is commenced. The biopsy is taken at gastroscopy and is a day stay procedure.

The treatment is to stop eating all foods with gluten in them, like bread and pasta. Sometimes the blood test may be only mildly abnormal and in this case, a repeat test may be necessary before referral to our service for endoscopy. Most children who have confirmed coeliac disease can be followed up by their general paediatrician or general practitioner once they have adjusted to the new diet.