How is coeliac disease diagnosed?
Understanding the coeliac disease diagnosis process is an important step if you’re experiencing symptoms or have concerns about your health. Getting an accurate diagnosis ensures you receive the right treatment and avoid long-term complications.
The coeliac disease diagnosis process
Step 1: GP Consultation and Blood Test
The first step is to visit your GP. They will arrange a coeliac disease blood test, which checks for specific antibodies in your blood.
This test is essential and often determines whether further investigation is needed. However, it’s possible to have a negative test and yet still have coeliac disease.
It’s important not to remove gluten from your diet at this could lead to a false negative result.
Step 2: Referral to a Specialist
If your blood test suggests coeliac disease or there is clinical suspicion of coeliac disease, your GP will refer you to a gastroenterologist (gut specialist) or children will be referred to a paediatric gastroenterologist or a paediatrician with a special interest in coeliac disease. This specialist will assess your symptoms and may recommend additional testing.
Step 3: Endoscopy and Biopsy
In many cases, a gut biopsy is carried out to confirm the diagnosis. A biopsy involves a camera called an endoscope being passed down into the small intestine, and a small sample of tissue is taken to check for damage caused by gluten.
For some children, a diagnosis may be possible without a biopsy, and a second blood test is needed to confirm the diagnosis.
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, there has been variable uptake of this approach and we look forward to a full updated guideline, to include a no biopsy strategy, which is expected in 2026.
Do not remove gluten from your diet until all tests are complete or until recommended by your gastroenterologist.
Keep Eating Gluten During Diagnosis
To ensure accurate results, you must continue eating gluten before and during testing.
The recommendation is to eat some gluten in more than one meal every day for at least six weeks before testing.
If you’ve already started to reduce or remove gluten, you will need to reintroduce it before testing. This is often referred to as a “gluten challenge.” This can be difficult, so it’s important to discuss this with your GP.
Frequently Asked Questions About Coeliac Diagnosis
There are home testing kits for coeliac disease available over the counter or online, but these do not give a confirmed medical diagnosis. However, it is important to see your GP and get medically diagnosed with coeliac disease.
You may need to complete a gluten challenge before accurate testing can be done. It is important to discuss this with your GP before testing.
In some cases, particularly in children, diagnosis may be made without a biopsy if blood test results are strongly positive.
Yes, false negatives can occur, especially if you are not eating enough gluten before testing.
If your GP still suspects coeliac disease after a negative blood test, you should be referred to a specialist for further investigations.
The coeliac disease diagnosis timeline can vary but once an individual has their blood test results and are referred to a specialist, national guidelines recommend an endoscopy should be performed within 6 weeks of their referral. However, waiting times can often be longer depending on an individual circumstances and local resources.
What Happens Next?
If you are diagnosed with coeliac disease, you will receive guidance on managing your condition, including adopting a strict gluten free diet. We offer a range of resources and support to help you get started.