As coeliac disease (CD) is a serious medical condition with lifelong complications, a conclusive diagnosis is vital for its management. There are a number of tests available to support a diagnosis of coeliac disease. For an adult, please refer to our adult diagnostic pathway pdf for more information.

For children, Starship Children’s Health and Coeliac New Zealand have created a unique partnership to offer better community support and care for children with coeliac disease. This has included the development of a new regional clinical pathway, for children who live in the Auckland, Waitemata and Counties Manukau District Health Board regions. For children, please refer to our child diagnostic pathway for more information.

Option 1: Recommend a gluten challenge. If gluten has already been removed from the diet, a normal gluten-containing diet must be resumed for at least 4-8 weeks before serology testing and biopsy. During this ‘gluten challenge’, a minimum of four slices of wheat based bread (or equivalent) should be consumed each day for 4-8 weeks, by adults.

Two slices of wheat-based bread each day for children, or gluten in at least two meals/day for 4 weeks. The gluten challenge must be carried out properly to ensure reliable test results.

Option 2: If your patient is reluctant or unable to complete a gluten challenge, offer HLA-DQ2/ 8 gene testing. If HLA DQ2/ 8 gene testing is negative coeliac disease can be safely excluded. If it is positive, then option 1 is the gold standard diagnostic approach.

"By taking the first step to gain a diagnosis, you can be confident that your symptoms are caused by CD. You can, therefore, receive the necessary support, information, and means to thrive on a gluten free diet."

A gluten free diet is not a negligible nor simple undertaking, as it brings about lifestyle changes and learning new skills such as reading and interpreting food labels. It should only be undertaken after the diagnosis of coeliac disease has been definitively and medically confirmed.