Stages of diagnosis
Understand the symptoms
Check if you have the symptoms of coeliac disease here.
Check for coeliac disease
If you have any of the symptoms listed, take our online assessment which is a short questionnaire on the symptoms and other risk factors. If the test result is positive, you can print it out and take to your GP for further discussion. If you’d rather just discuss your symptoms with your GP, then make sure to book an appointment. Take the assessment now.
Have a blood test
If your GP thinks you need further testing, they will take a simple blood test to check for antibodies. These can indicate coeliac disease. However, it’s possible to have a negative test and yet still have coeliac disease. Do not remove gluten from your diet at this stage.
Referral to a specialist
If the blood test is positive or negative but there is clinical suspicion of coeliac disease your GP will then refer you to a gut specialist (a gastroenterologist).
Coeliac disease in adults is traditionally diagnosed by a blood test and gut biopsy, but in response to the Covid-19 pandemic, interim guidelines were published for a no-biopsy diagnosis in some adults. Since then, further research has supported this diagnosis pathway, and the updated 2026 guidelines from the British Society of Gastroenterology formally recognises some adults may be diagnosed with coeliac disease from a single blood test when assessed by a gastroenterologist in discussion with the patient.
For children, a biopsy may not be necessary in every case, but the diagnosis of coeliac disease should be made in secondary care. NICE recommends that children are referred to a paediatric gastroenterologist or paediatrician with a special interest in gastroenterology for further investigation.
Do not remove gluten from your diet until all tests are complete or until recommended by your gastroenterologist.
If you test positive for coeliac disease, we have lots of information on how to manage your condition.
There are home testing kits for coeliac disease available over the counter or online, but these do not give a confirmed medical diagnosis. Therefore, it is important to see your GP and get medically diagnosed with coeliac disease.
Keep eating gluten throughout the diagnosis process
If you think you may have coeliac disease, it’s essential to continue eating gluten until your doctor makes a diagnosis.
The diagnostic tests for coeliac disease look at how the body responds to gluten.
Some people may start to reduce or eliminate gluten from their diet because they feel ill. Unfortunately, this is very likely to cause an inaccurate result for both the blood test and the gut biopsy.
Therefore, it’s very important to keep eating gluten throughout the diagnosis process.
If you’ve already reduced or eliminated gluten from your diet, you will need to reintroduce it to make sure you get the most accurate test results. While it may be difficult and uncomfortable, it’s essential for your long-term health.
The recommendation is to include at least 3g but preferably 6g of gluten every day for at least six weeks before testing and throughout the diagnosis process. The table below provides examples of food portions that contain 3g of gluten that can be used for a gluten challenge.
| Gluten containing food | 3g of gluten |
| Sourdough Spelt Bread | 60g (1.5 – 2 slices bread / medium bread roll) |
| Wheat-based breakfast cereal e.g. Shredded wheat/ Weetabix | 25g wheat-based cereal such as two Weetabix or two fist-sized portions of cereal |
| Wheat-based bread | 60g (1.5 – 2 slices bread / medium bread roll) |
| Wheat-based cooked pasta | 90g of cooked pasta (a fist-size portion) |
| Wheat-based biscuits | 50g (3-5 biscuits) |
| Wheat Gluten Flour or Vital Wheat Gluten | 7.5g (1.5-2 teaspoons) |
For children, you can mix wheat flour into foods such as yogurt or baked beans to add more gluten into their diet.
If you are reintroducing gluten into your diet, you should discuss how best to manage your symptoms with your GP. Your GP will be able to arrange for you to be tested for coeliac disease as soon as it is appropriate.
We understand how hard it is to get diagnosed if you have started a gluten free diet. Getting a medical diagnosis, however, is important to ensure you get the medical follow up and support that is recommended for people with coeliac disease. Unfortunately, there are no other tests that can diagnose coeliac disease other than the antibody blood test and the gut biopsy. These tests depend on people eating gluten.