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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Partly. A doctor can assess your symptoms, plan your tests and help with follow-up by video; blood tests, any biopsy and bone scans are done in person.
- What it is: an autoimmune condition in which gluten, a protein in wheat, barley and rye, damages the lining of the small intestine.
- How common: about 1 in 100 people. In the UK, only 36% of them are diagnosed.
- Before testing: keep eating gluten. If you have cut it out, you need 3 to 6 g of gluten a day for at least 6 weeks before the blood test.
- Emergency: call 112 for vomiting blood, black tar-like poo, or sudden severe tummy pain with a rigid, very tender belly.
Coeliac disease is rarely an emergency. Do not book a video appointment if you are vomiting blood or material that looks like coffee grounds, have black, tar-like poo or heavy bleeding from the bottom, or have sudden severe tummy pain or a rigid, very tender belly. Call 112 or go to an emergency department.
Can an online doctor treat coeliac disease?
Partly. Coeliac disease is confirmed with a blood test and, for most adults, a biopsy taken during an endoscopy, and both are done in person. A doctor by video can go through your symptoms and your risk, tell you whether testing makes sense and how to prepare for it, explain your results, and help with life after diagnosis: low iron or vitamin levels, symptoms that come back, the itchy rash linked to coeliac disease, and eating gluten-free at home and abroad. The doctor can provide a referral letter when one is needed.
How an online consultation helps with coeliac disease
- Testing that makes sense: Your symptoms, your family and your other conditions show whether a coeliac blood test is worth doing.
- Ready for the tests: Why you must keep eating gluten until every test is done, and how much is enough.
- Results explained: What a positive or a negative result means, and what the specialist does next.
- Life after diagnosis: Low iron or vitamins, symptoms that come back, the rash, and eating gluten-free while you travel.
What the doctor checks in an online coeliac disease consultation
The doctor checks for warning signs first, then for the pattern that points to coeliac disease. The doctor asks about:
- Warning signs: blood in your poo or vomit, black poo, weight loss you cannot explain, difficulty swallowing, or a lump in your tummy.
- Your gut: diarrhoea, greasy, frothy or foul-smelling poo, bloating, wind, tummy pain and constipation, and how long they have gone on.
- The rest of you: tiredness, mouth ulcers, an itchy rash with blisters, tingling or numbness in the hands or feet, and difficulty getting pregnant.
- Your diet: how much gluten you eat now, and whether you have already cut down.
- Your family and health: a parent, brother, sister or child with coeliac disease, type 1 diabetes, thyroid disease, and the medicines you take.
Before the call, gather any recent blood test results, and note what you eat on a typical day and when your symptoms are worse.
What is coeliac disease?
Coeliac disease is an autoimmune condition: the immune system reacts to gluten, a protein in wheat, barley and rye, and attacks the lining of the small intestine. Gluten flattens the tiny finger-like projections, called villi, that absorb food, which can lead to shortages of iron, vitamins and minerals. It is not a food allergy or an intolerance, and the damage can happen without symptoms. There is no cure, but a strict gluten-free diet for life lets the gut heal.
How common is coeliac disease?
About 1 in 100 people have coeliac disease. In the UK, only 36% of them are diagnosed, which leaves an estimated 500,000 people who do not know they have it, partly because milder symptoms are mistaken for irritable bowel syndrome. It can start at any age, and it is diagnosed more often in women than in men.
Is coeliac disease genetic?
Partly. It runs in families: if a parent, brother, sister or child has it, your chance rises to about 1 in 10, so close relatives should be tested. It needs certain genes, HLA-DQ2 or HLA-DQ8, but around 30 to 40% of people in Western populations carry them and most never develop it. Not carrying either gene makes coeliac disease very unlikely.
What are the symptoms of coeliac disease?
Symptoms range from mild to severe, and they often come and go. In adults, they fall into a few groups:
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| Type | Symptoms | What is behind them |
|---|---|---|
| Gut | Diarrhoea that may smell particularly unpleasant, tummy pain, bloating and wind, indigestion, constipation, vomiting | Inflammation of the small intestine |
| Poo | Greasy, frothy, foul-smelling poo (steatorrhoea) | Fat that is not absorbed |
| Whole body | Tiredness, weight loss without trying, and anaemia from low iron, vitamin B12 or folate | Nutrients that are not absorbed |
| Skin and mouth | An itchy rash with blisters (dermatitis herpetiformis), and severe or persistent mouth ulcers | Linked to eating gluten |
| Nerves | Tingling and numbness in the hands and feet, and problems with coordination, balance and speech | Effects on the nerves |
| Fertility | Difficulty getting pregnant | Untreated coeliac disease |
Some people have no symptoms, sometimes called silent coeliac disease, and are diagnosed during tests for something else, such as anaemia. A gluten-free diet is still recommended, because the damage and the complications can happen without symptoms.
Coeliac disease or IBS?
The gut symptoms overlap with irritable bowel syndrome, and mild coeliac disease is often mistaken for it. That is why adults with IBS-type symptoms are advised to have a coeliac blood test.
How is coeliac disease diagnosed?
Coeliac disease is diagnosed with a blood test, usually followed by a biopsy of the small intestine. Both only work while gluten is still in your diet:
- Keep eating gluten. If you have already cut it out, the tests can be falsely negative. The 2026 British guideline advises 3 to 6 g of gluten a day for at least 6 weeks before testing; 3 g is about 60 g of wheat bread or 90 g of cooked wheat pasta.
- A blood test for antibodies. The first test looks for IgA tissue transglutaminase (tTG) antibodies, with a check for a low level of IgA, which stops these antibodies showing. You can have coeliac disease without the antibodies, so symptoms that continue after a negative test still need a specialist.
- A biopsy, for most people. A gastroenterologist passes a thin tube with a camera (an endoscope) through your mouth, with a local anaesthetic to numb your throat and sometimes a sedative, and takes tiny samples of the small intestine to look at under a microscope.
- No biopsy, for some adults. Under the 2026 British guideline, adults with symptoms who see a specialist can be diagnosed without a biopsy when the tTG level is at least 10 times the upper limit of normal, if they agree after discussing it.
- Checks after diagnosis. Blood tests for iron and vitamins, and a bone density (DEXA) scan, which the guideline advises for all newly diagnosed adults 1 year after starting the diet.
Do not start a gluten-free diet until a specialist confirms the diagnosis, even if the blood test is positive. Home test kits sold online or in shops cannot confirm coeliac disease.
Who should be tested for coeliac disease?
A blood test is advised if you have any of these:
- stomach or bowel symptoms that keep going without a clear cause, including IBS-type symptoms
- tiredness that lasts, or weight loss without trying
- severe or persistent mouth ulcers
- unexplained low iron, vitamin B12 or folate
- type 1 diabetes or autoimmune thyroid disease
- a parent, brother, sister or child with coeliac disease
It is also worth considering for early bone thinning, unexplained nerve symptoms, infertility or repeated miscarriages, and liver blood tests that stay raised.
Coeliac disease, gluten sensitivity or wheat allergy?
Three different conditions can make people unwell after eating gluten or wheat, and only coeliac disease damages the gut. Telling them apart matters, because they need different care:
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| What differs | Coeliac disease | Gluten sensitivity | Wheat allergy |
|---|---|---|---|
| What it is | An autoimmune reaction to gluten | Symptoms after gluten or wheat without coeliac disease or a wheat allergy | A food allergy to wheat |
| Damage to the small intestine | Yes | No | No long-term damage |
| Typical symptoms | Diarrhoea, bloating, tiredness, anaemia, or none | Tummy pain, bloating, wind, diarrhoea, tiredness, headache, brain fog | Itchy skin or eyes, swelling, wheezing or trouble breathing |
| How it is confirmed | Blood test, and usually a biopsy, while eating gluten | Only by ruling out coeliac disease and wheat allergy; no test confirms it | Skin-prick and blood tests by an allergy specialist |
| Diet | Strictly gluten-free for life | Adapted to your own triggers, usually less strict | Avoiding wheat |
Feel better without gluten but never been tested? A doctor can help you decide whether a gluten challenge and testing are worthwhile. Other causes of bloating are on the bloating page.
What can you eat with coeliac disease?
Anything without wheat, barley or rye, and many foods are naturally gluten-free. The hard part is hidden gluten:
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| Group | Examples |
|---|---|
| Contains gluten: avoid | Wheat, including spelt, durum, semolina, farina, bulgur and couscous; barley and rye; most bread, pasta, breakfast cereals, biscuits, crackers, cakes, pastries and pies; most beers |
| Often hidden: check the label | Sauces, gravies, stock, soups, soy sauce, dressings, processed meats, battered or breaded food, malted drinks, malt flavouring, modified food starch, sweets, ice cream, baking powder and some medicines |
| Naturally gluten-free | Fresh fruit and vegetables, plain meat, fish and eggs, most dairy, potatoes, rice and rice noodles, corn, quinoa, buckwheat, nuts, seeds and pulses |
| Gluten-free versions | Bread, pasta, pizza bases and flour labelled gluten-free, and rice, corn, soy or potato flour |
Are oats gluten-free?
Oats do not contain gluten, but ordinary oats are often contaminated with wheat, barley or rye. Pure oats labelled gluten-free suit most people with coeliac disease, and the 2026 British guideline advises discussing them as soon as the diet starts. A small number of people react to avenin, a protein in oats themselves.
Reading gluten-free labels in Europe
Across the EU, food can only be labelled gluten-free if it contains no more than 20 mg of gluten per kg (20 parts per million), a trace that most people with coeliac disease tolerate. ‘Very low gluten’ allows up to 100 mg per kg, so it is not the same. Oats in a gluten-free product must be produced to avoid contamination and stay within the same 20 mg limit. The Crossed Grain symbol, a gluten-free mark, appears on more than 21,000 products across Europe.
Avoiding cross-contamination
- Store gluten-free food in sealed, labelled containers, and use separate spreads or a ‘single-dip’ rule.
- Cook gluten-free pasta in fresh water, and fry gluten-free food in clean oil.
- Keep utensils, appliances and surfaces clean, and wash your hands after handling gluten.
How long until you feel better?
Symptoms usually improve considerably within weeks of going gluten-free, and full healing of the gut can take up to a few years. Up to a third of people still have symptoms despite trying to follow the diet, often because gluten is still getting in; other causes, such as IBS, can add to them.
Is coeliac disease serious? Complications
Complications mainly affect people who keep eating gluten or who have not been diagnosed:
- Anaemia: from low iron, or from low vitamin B12 or folate.
- Weak bones (osteoporosis): from nutrients that are not absorbed well.
- Lactose intolerance: more likely while the gut is damaged, and it usually improves once the gut recovers. See lactose intolerance.
- Pregnancy problems: poorly controlled coeliac disease raises the risk of complications such as low birth weight.
- Cancer, rarely: a slightly higher risk of small bowel cancer, small bowel lymphoma and Hodgkin lymphoma. Most people with coeliac disease never get these cancers.
- Refractory coeliac disease: rarely, symptoms and gut damage continue despite a strict diet, and specialists treat it.
Can coeliac disease kill you?
Rarely. Its most serious complications, such as small bowel lymphoma, are very rare, and after some time on a gluten-free diet the cancer risk returns to that of the general population.
Which coeliac disease treatment might the doctor recommend?
What happens next depends on whether you have been tested and how you are doing. This is the framework the doctors use, in line with the 2026 British guideline:
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| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Symptoms that could be coeliac disease, still eating gluten | A coeliac blood test | Yes, to assess | For the blood test |
| Feeling better without gluten, never tested | A gluten challenge, then the blood test | Yes, to plan | For the blood test |
| A positive blood test | Referral to a gastroenterologist | Yes, to explain | For a biopsy or the specialist’s decision |
| Diagnosed and doing well | A yearly review of symptoms, weight and diet | Yes | For blood tests |
| Low iron, folate or other vitamins | Supplements, and a check of the diet | Yes | For blood tests |
| Symptoms back on a gluten-free diet | A search for hidden gluten, then tests for other causes | Partly | For tests and specialist care |
| An itchy rash with blisters | Assessment for dermatitis herpetiformis | Yes, to assess | For a skin biopsy |
| Vomiting blood, black poo or sudden severe tummy pain | Emergency care | No | Call 112 now |
Not sure whether you should be tested for coeliac disease? A doctor can tell you in one consultation, and explain how to prepare.
See available times →Treatment options for coeliac disease
What you can do yourself
- Once the diagnosis is confirmed, cut out wheat, barley and rye for life, and read every label.
- Ask for a referral to a specialist dietitian, who helps you keep the diet balanced and spot hidden gluten.
- Ask the pharmacist whether a medicine contains gluten.
- Ask about the pneumococcal vaccine, which the 2026 British guideline advises for all adults with coeliac disease.
Prescription treatment
A prescription is never issued without a consultation. No medicine treats coeliac disease itself: the treatment is a gluten-free diet. When blood tests show low iron, folate or other vitamins and minerals, the doctor may prescribe supplements while the gut heals. The rash of dermatitis herpetiformis can take longer to clear than the gut symptoms, and a specialist may add dapsone tablets, which need regular blood tests. Refractory coeliac disease is treated by specialists, with steroids or other medicines that calm the immune system. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Cutting out gluten before you are tested, which can hide coeliac disease. Home test kits, which cannot confirm it. Foods labelled ‘very low gluten’ or ‘wheat-free’, which can still contain gluten. Eating a little gluten now and then: only a very small amount can damage the small intestine, even when you notice nothing.
Special situations
Pregnancy and fertility
Untreated coeliac disease can make it harder to get pregnant, and poorly controlled disease raises the risk of complications such as low birth weight. If you have coeliac disease and are planning a pregnancy, tell the doctor, so your diet and nutrient levels can be checked.
Eating out, social life and travel in Europe
A strict diet can make meals out, work events and trips harder, and a specialist dietitian and a coeliac society offer practical support. Gluten-free labels mean the same 20 mg per kg limit in every EU country. Learn the local words, such as sin gluten in Spanish, senza glutine in Italian, sans gluten in French and glutenfrei in German, carry gluten-free snacks for journeys, and ask how food is cooked, because shared fryer oil and pasta water can carry gluten.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When coeliac disease is treated online, and when you need in-person care
Treated online: deciding whether you need tests, planning a gluten challenge, explaining results, yearly reviews, low iron or vitamin levels, symptoms that come back, and advice on eating gluten-free at home and abroad.
In-person care: blood tests, endoscopy and biopsy, a skin biopsy for the rash, bone density scans, vaccinations, refractory coeliac disease, and any warning sign.
When to get in-person care
Call 112 or go to an emergency department now for:
- vomiting blood, or vomit that looks like coffee grounds
- black, sticky, tar-like poo, or heavy bleeding from the bottom
- sudden, severe tummy pain, or a belly that is rigid or very painful to touch
- being unable to pass poo or wind, with a swollen tummy and vomiting
Get medical advice the same day for:
- blood in your poo, or bloody diarrhoea
- difficulty swallowing
- losing weight without trying
- diarrhoea that lasts more than a few days
A lump in your tummy, or a change in your bowel habit that lasts, needs prompt tests in person: see a doctor rather than waiting for it to settle.
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your symptoms: say what you eat, how long the symptoms have lasted and whether anyone in your family has coeliac disease, and have any blood test results to hand.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s coeliac disease? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Irritable Bowel Syndrome (IBS) can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about coeliac disease
What is coeliac disease?
Coeliac disease is an autoimmune condition in which the immune system reacts to gluten, a protein in wheat, barley and rye, and damages the lining of the small intestine. It is not an allergy or an intolerance, and it is treated with a strict gluten-free diet for life.
What are the symptoms of coeliac disease?
Diarrhoea, tummy pain, bloating and wind, tiredness and weight loss without trying are the common symptoms of coeliac disease. Some people only have anaemia, mouth ulcers or an itchy rash with blisters, and some have no symptoms at all.
What causes coeliac disease?
Coeliac disease is caused by an immune reaction to gluten in people who carry the HLA-DQ2 or HLA-DQ8 genes, which about 30% of Europeans have, although only a few of them develop it; something, perhaps a gut infection, a change in gut bacteria or the timing of gluten in infancy, tips the immune system into attacking the intestine. It is not caused by eating too much gluten, and it is not an allergy, so the amount tolerated is zero rather than small.
Is it coeliac or celiac disease?
Both spellings mean the same condition: coeliac is the British and European spelling and celiac the American one, and the medical name, coeliac disease or gluten-sensitive enteropathy, is the same everywhere. It matters only when searching: European guidance, support groups and food labelling use coeliac, while much research and many US sites use celiac, and the advice applies equally.
How do you test for coeliac disease?
With a blood test for coeliac antibodies while you are still eating gluten, usually followed by a biopsy of the small intestine taken during an endoscopy. Some adults with very high antibody levels can be diagnosed by a specialist without a biopsy.
Do I need to eat gluten before a coeliac test?
Yes. If you have cut gluten out, the coeliac tests can be falsely negative. The 2026 British guideline advises 3 to 6 g of gluten a day, about 60 to 120 g of wheat bread, for at least 6 weeks before testing.
What foods contain gluten?
Wheat, including spelt, semolina and couscous, barley and rye, and foods made from them, such as most bread, pasta, cereals, cakes and beer. For someone with coeliac disease, gluten also hides in sauces, gravies, stock, soy sauce, processed meats and some medicines.
What helps when managing coeliac disease day to day?
Learn to read labels for wheat, barley, rye and oats not labelled gluten-free, keep separate toasters, boards and butter to avoid crumbs, choose naturally gluten-free foods such as rice, potatoes, meat, fish, eggs, fruit and vegetables, carry safe snacks, use restaurant translation cards abroad, join a coeliac society for product lists, have your iron, vitamin D and B12 checked, and keep annual follow-up. Symptoms returning on a careful diet usually mean hidden gluten rather than failed treatment.
What is silent coeliac disease?
Coeliac disease with few or no symptoms, often found during tests for something else, such as anaemia. The gut can still be damaged, so a gluten-free diet is still recommended to prevent complications.
How long does coeliac disease take to improve on a gluten-free diet, and what is the outlook?
Symptoms of coeliac disease usually ease within 2 to 4 weeks of a strict gluten-free diet, blood antibodies fall over 6 to 12 months, and the intestinal lining heals over 1 to 2 years in most adults, more slowly over 50. Coeliac disease is lifelong and returns with any gluten, but on the diet the outlook is normal: energy, weight and iron recover, bone density improves, and the small extra cancer risk falls back to that of everyone else.
Is coeliac disease genetic?
Coeliac disease runs in families. If a parent, brother, sister or child has it, your chance is about 1 in 10. It needs certain genes, HLA-DQ2 or HLA-DQ8, but most people who carry them never develop it.
Can coeliac disease be prevented?
No. Coeliac disease cannot be prevented, because it depends on inherited genes and an immune trigger nobody can control; delaying or hurrying gluten in a baby’s diet, breastfeeding patterns and gluten-free eating by people without the condition have all been studied and do not prevent it. What prevention does mean is testing first-degree relatives, who have a 1 in 10 chance, so the damage, anaemia and bone loss of untreated coeliac disease are caught early.
Can you develop coeliac disease later in life?
Yes. Coeliac disease can develop at any age, even after decades of eating gluten without problems; most people are now diagnosed as adults, often in their 40s and 50s, and it is sometimes unmasked by a stressful event, pregnancy, surgery or a gut infection. Symptoms that start later in life are often subtler, such as anaemia, tiredness or osteoporosis rather than diarrhoea, which is why it is missed.
Can coeliac disease kill you?
Rarely. The most serious complications of coeliac disease, such as small bowel lymphoma, are very rare, and after some time on a strict gluten-free diet the cancer risk returns to that of the general population.
Can an online doctor help with coeliac disease?
Partly. A doctor can assess your coeliac symptoms by video, plan your tests, explain the results, and help with follow-up, low iron or vitamins and symptoms that come back. The blood test, biopsy and bone scans are done in person.
- Coeliac disease, NHS, National Health Service (UK), reviewed 31 March 2023.
- Coeliac disease: symptoms, NHS, National Health Service (UK), reviewed 31 March 2023.
- Coeliac disease: diagnosis, NHS, National Health Service (UK), reviewed 31 March 2023.
- Coeliac disease: treatment, NHS, National Health Service (UK), reviewed 31 March 2023.
- Coeliac disease: complications, NHS, National Health Service (UK), reviewed 31 March 2023.
- The 2026 British Society of Gastroenterology guidelines on the diagnosis and management of adult coeliac disease, Penny HA et al., Gut, British Society of Gastroenterology, 2026.
- About coeliac disease, Coeliac UK, updated 3 July 2026.
- Getting diagnosed, Coeliac UK, updated 12 October 2026.
- Definition and facts for celiac disease, NIDDK, US National Institutes of Health, reviewed October 2020.
- Coeliac disease and gluten sensitivity, Better Health Channel, Victoria State Government (Australia), reviewed 15 November 2021.
- Non-coeliac wheat or gluten sensitivity: how is it different from coeliac disease?, Digestive System Service, Hospital Universitari de Bellvitge (Spain), updated 28 July 2026.
- Food allergy, NHS, National Health Service (UK), reviewed 20 August 2026.
- Stomach ache, NHS, National Health Service (UK), reviewed 26 May 2023.
- Commission Implementing Regulation (EU) No 828/2014 on information on the absence or reduced presence of gluten in food, European Union, EUR-Lex, 30 July 2014.
- The Crossed Grain symbol, Coeliac UK, 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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