Coeliac disease has historically been considered a rare gastro-intestinal disorder with most clinicians expecting to recognize the overt childhood presentation of chronic diarrhoea, malabsorption and failure to thrive. In fact, it is estimated to affect 1% of the general population, often presenting in adulthood with a multitude of intestinal and extra-intestinal manifestations. It is a chronic, permanent, autoimmune condition, which if left untreated, can be potentially life threatening. The only effective treatment is complete, lifelong removal of gluten from the diet with long-term follow-up. Currently, for every adult patient diagnosed, eight cases are estimated to go undetected, indicating a failure in case finding in primary care. This article aims to improve symptom awareness of coeliac disease, highlight common pitfalls in diagnosis and management, discuss common associations and provide guidance in gluten-free prescribing.
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