Coeliac Disease

An immune reaction to gluten (found in wheat, barley, rye and oats) that damages the lining of the small bowel. Affects about 1 in 70 Australians, but most don’t know they have it. Symptoms vary: bloating, diarrhoea, tiredness, low iron, mouth ulcers, or none at all. Untreated, it can lead to thin bones and poor growth in children.

Treatment options

Ratings show how strong the research is.

• Strong evidenceStrict gluten-free diet, for lifeThe only treatment. Even small amounts of gluten cause bowel damage, with or without symptoms. Most people feel better within weeks, and the bowel heals over months to years.
• Moderate evidenceSee a dietitianHelps you read labels, avoid hidden gluten and cross-contamination, and still eat a balanced diet. Ask your GP about a care plan for Medicare-subsidised visits.
• Moderate evidenceCorrect low levelsMany people need iron, vitamin B12, folate, vitamin D or calcium for a while. Adults may need a bone density scan.
• Moderate evidenceRegular check-upsBlood tests at about 6 and 12 months, then yearly, to check your antibodies are falling and your levels are normal.
• Limited evidenceOatsSome people react to oats even when uncontaminated. In Australia, oats can’t be labelled gluten free. Only try them with your doctor’s guidance.
• Not recommendedGoing gluten-free before testingMakes the tests unreliable. Many people then need to eat gluten again for weeks to be tested properly.
• Not recommended"Gluten-digesting" enzyme pillsDon’t protect the bowel. They are not a substitute for the diet.

What you can do

• Keep eating gluten until testing is finished. Adults need about 4 slices of wheat bread a day (children about half) for at least 6 weeks before testing.
• Testing starts with a blood test. If positive, a gastroscopy (camera test) with small bowel samples usually confirms it. A negative gene test rules coeliac disease out.
• Ask parents, brothers, sisters and children to get tested: about 1 in 10 also have it, often without symptoms.
• Check medicines and supplements for gluten with your pharmacist.

See your GP if

• Symptoms continue despite a strict gluten-free diet
• You have another autoimmune condition, such as type 1 diabetes or thyroid disease, and haven’t been tested
• A family member has coeliac disease

See a doctor promptly for unexplained weight loss, blood in your poo, trouble swallowing or vomiting that won’t settle. These need checking for other causes.

Evidence and more information

• Healthdirect: Coeliac disease
• Better Health Channel: Coeliac disease and gluten sensitivity
• Coeliac Australia: Gluten challenge fact sheet

Reviewed October 2026. General education, not personal medical advice. Treatment depends on your situation, so talk to your GP or pharmacist.

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