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Coeliac Disease – the right tests are vital for a correct diagnosis

Imagine being told that you couldn’t grab a sandwich from the high street at lunchtime or that you couldn’t enjoy Sunday lunch, covered in your mum’s legendary gravy. Picture yourself at a buffet table, knowing that you couldn’t eat the majority of foods on offer or being in a restaurant struggling to find something on the menu that you can eat.

These are examples of what thousands of people with coeliac disease have to cope with every day.

Coeliac disease is an autoimmune disease which means that gluten, found in wheat, barley and rye, triggers an immune reaction in the sufferer, damaging the lining of the small intestine. It can increase the risk of developing osteoporosis (thinning of the bones) and certain types of cancer. It can also cause malnutrition which results in fatigue, weight loss and susceptibility to infections.

In the past, coeliac disease was identified by a blood test however using this to diagnose coeliac disease was not always 100% conclusive. Despite this, most patients were diagnosed with the condition and prescribed a strict gluten free diet that they were committed to eat for the rest of their life.

In recognition of the clinical guidelines for coeliac disease provided by the National Institute for Clinical Excellence (NICE), NHS Vale of York Clinical Commissioning Group (CCG) is working with local GP practices to conduct a review of the patients that have been prescribed a gluten free diet.

NICE states that coeliac disease should be diagnosed by a blood test and a biopsy of the gut and the CCG wants to ensure that patients have the opportunity to be  diagnosed by a biopsy to ensure that they have not been prescribed a special diet unnecessarily.

Dr Shaun O’Connell, the CCG’s clinical lead for prescribing, said: “Living a gluten free diet can be restricting. We want to ensure our patients have been properly diagnosed.

“It is important to make sure that patients have a biopsy to confirm diagnosis to protect them from the long term risk of coeliac disease if they do have it, or to enable them to return to a normal diet if they don’t.

“Following a special diet can be difficult, whatever the age of the patient and, if it is not necessary to eat prescribed foods, I’m sure that those who currently eat gluten free products would prefer to eat with no restrictions.

“This is even more important for teenagers reaching 18 years old who may have been diagnosed as a child by a blood test only and now have the choice of a diagnosis that has been recommended by NICE.

“The biopsy test would also ensure that coeliac patients can be properly managed by their GP on a regular basis.”

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