Positive Coeliac Antibodies

This condition is treated in the Gastroenterology clinic.

Pre-referral work-up

History

All referrals should comply with referral standards and specifically include:

• Family history
• Duration of symptoms
• Pattern and severity of symptoms

Tests

Pathology:

• LFT
• FBC
• U&E
• Coeliac serology (TTG) NB:If patients are on a gluten-free diet, advise them to add gluten to their diet for four weeks before diagnostic testing
• Iron study (if applicable)
• Coeliac gene studies (if available)

Imaging:

Nil

Investigations:

Nil

Interim/GP management

To refer a patient with this condition, please see the Gastroenterology clinic page for the full referral process and templates.

Note: Please do not start on gluten-free diet until after biopsy has been performed.

For more information please see the HealthPathways Tasmania website.

GESA Guideline: Coeliac Disease (2007)

Clinic appointments

? Red location flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency

? Potentially life-threatening symptoms suggestive of:

• acute upper GI tract bleeding
• acute severe lower GI tract bleeding
• oesophageal foreign bodies/food bolus
• bowel obstruction
• abdominal sepsis
• Acute Severe Colitis - see Note

? Severe vomiting and/or diarrhoea with dehydration
? Acute/fulminant liver failure (to be referred to a centre with dedicated hepatology services
? Biliary sepsis (to be referred to a centre with ERCP service)

Note -Acute severe colitis as defined by the Truelove and Witts criteria - all patients with greater than or equal to 6 bloody bowel motions per 24 hours plus at least one of the following:

• temperature at presentation of over 37.8°C,
• pulse rate at presentation of over 90 bpm,
• haemoglobin at presentation of under 105 gm/l, CRP over 30mg/dl at presentation (or ESR over 30 mm/hr)

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Urgent (Category 1)

Positive coeliac serology with concerning features select those that apply:

• diarrhoea significantly impacting on activities of daily living
• bloody or nocturnal diarrhoea
• weight loss, greater than or equal to 5% of body weight in previous 6 months
• persistent abdominal pain
• iron deficiency in males and postmenopausal women or unexplained iron deficiency in premenopausal women

We will endeavour to see these patients within four weeks

Urgent referrals should be accompanied by a phone call to the clinic and the relevant doctor for urgent assessment, or patient should be directed immediately to the Emergency Department.

Semi-urgent (Category 2)

Positive coeliac serology without concerning features (as above)

Availability

North

Launceston General Hospital
Level 3 - Specialist Clinics

Phone: 1300 977 694
Fax: 03 6777 5227

North West

All North West referrals are managed via  Mersey Community Hospital
Phone: 03 6478 5222
Fax: 03 6441 5942

South

Wellington Clinics (Level 10)
Phone: 03 6166 0000
Fax: 03 6234 3982