Coeliac Disease Diagnosis & Management in Christchurch

The common symptoms of Coeliac Disease are:

• Persistent bloating and abdominal pain.

• Unexplained iron-deficiency anaemia or B12 deficiency.

• Chronic fatigue or "brain fog."

• Unintended weight loss.

• Changes in bowel habits, such as chronic diarrhoea or constipation.

While blood tests (serology) are an important first step, in adults, Gastroscopy is generally required to confirm the diagnosis.

1. Gastroscopy and Biopsy

During a gastroscopy performed at our Christchurch facility, Dr Mehul Lamba will take small tissue samples (biopsies) from the lining of the small bowel (duodenum). This is a quick, routine procedure typically performed under sedation for your comfort.

2. Pathological Review

The biopsy samples are examined under a microscope by a specialist pathologist. They look for two hallmark features of coeliac disease: villous atrophy (flattening of the tiny finger-like projections that line the small bowel and absorb nutrients) and lymphocytic infiltration (an increase in inflammatory cells within the gut lining). Together, these microscopic changes confirm the diagnosis. 

The blood tests are generally very reliable, and with negative serology, the likelihood of Coeliac disease is very low. However, if symptoms persist, Gastroscopy may still be indicated to assess for coeliac disease, but more importantly, exclude other conditions mimicking coeliac disease.

To ensure the biopsy results are accurate, you must be consuming 10 grams of gluten daily (equivalent to 2 to 4 slices of bread) for at least 4-6  weeks leading up to your procedure. If you have already started a gluten-free diet, please contact our Christchurch clinic for specific advice on a "gluten challenge."

A diagnosis is the first step toward recovery. Once coeliac disease is confirmed, we will provide you with a detailed report for your GP and can refer you to a specialist registered dietitian in Christchurch who specializes in gluten-free transitions. We also recommend baseline blood tests to check for nutritional deficiencies (like Iron, Vitamin D, and B12) and, in some cases, a bone density (DEXA) scan.

It is possible to have Non-Coeliac Gluten Sensitivity (NCGS). This is a condition where individuals experience symptoms similar to coeliac disease—such as bloating, abdominal pain, and fatigue—that improve when gluten is removed, even though their blood tests and bowel biopsies are normal.

Because there is currently no specific "test" for NCGS, the diagnosis is made by first definitively ruling out coeliac disease and wheat allergies. At our Christchurch clinic, we focus on ensuring you have a clear diagnostic answer before you commit to long-term dietary restrictions, as the management for sensitivity differs from the strict medical requirements of coeliac disease.

Coeliac disease has a strong genetic component. First-degree relatives (parents, siblings, and children) have approximately a 1-in-10 lifetime risk of developing the condition. We recommend that if family members develop any suggestive symptoms, they are encouraged undergo a specific blood test to assess for coeliac disease. It is important they remain on a gluten-containing diet until the testing is complete.