When is blood test recommended for coeliac disease?

Coeliac disease is an immune reaction to gluten that can affect the small intestine. Blood testing usually looks for coeliac-related antibodies and may include a check that the body can produce the antibody being measured. The test is most informative while you are still eating gluten. Starting a gluten-free diet first can make results harder to interpret. Possible clues include ongoing diarrhoea, bloating, abdominal discomfort, iron deficiency, tiredness, poor growth, or an associated autoimmune condition. A positive blood result generally needs a clinician-led follow-up, which may include specialist assessment.

Tell the clinician about your symptoms, family history, current diet, and any supplements. Unless a clinician has told you otherwise, do not remove gluten before testing; ask how much and for how long you should continue eating it. Do not interpret a negative result as proof that every digestive symptom has been explained. If symptoms continue, arrange review. Children, pregnant people, and anyone with significant weight loss may need an especially tailored plan.

Seek prompt medical attention for severe dehydration, black or bloody stools, repeated vomiting, fainting, intense abdominal pain, or rapidly worsening weakness. Arrange a timely appointment for ongoing diarrhoea, unexplained weight loss, persistent vomiting, or signs of anaemia. These symptoms need assessment whether or not coeliac disease is eventually found.

Should I keep eating gluten before the test? Which antibodies are being checked? What will happen if the result is positive or unclear? If the result is negative but symptoms remain, what other causes should we assess?