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​Coeliac diagnoses increase despite GPs ordering fewer tests

The number of coeliac cases diagnosed in the UK rose by a quarter between 2011 and 2015, despite the fact that GPs ordered fewer diagnostic tests, a new study has said.

The researchers, from the University of Nottingham, suggested this could be down to a more targeted approach to diagnosis by GPs.

The study, presented at the Coeliac UK Research Conference, analysed the incidence of coeliac disease and the use of serological testing.

Studying coeliac cases between 2005 and 2015, the researchers found that as the rate of testing increased, so did the rate of diagnosis.

However, despite testing falling dramatically after 2011, the prevalence of coeliac diagnoses continued to rise, with an additional 45,000 people diagnosed between 2011 and 2015, representing a 25% increase.

The paper suggested that the decline in testing could be down to 'lack of resource', a 'more targeted use of testing', or could mean that the 'threshold of clinically identifiable coeliac disease has been reached' and so a steady incidence rate has been obtained.

But Coeliac UK’s chief executive Sarah Sleet is still urging patients to see their GP and request to be tested.

She said: ‘The blood test for coeliac disease is relatively quick and cheap and we urge anyone that has ongoing symptoms to visit their GP and request to be screened for coeliac disease...

'Diagnoses have increased as a result of the cumulative effect over many years of people being diagnosed with the condition which is lifelong and once diagnosed is associated with a normal lifespan. In fact, what the figures show is that the number of new diagnoses has levelled off with the levelling off of tests ordered.

'Time and again, aggressive case finding with a low index of suspicion and following NICE guidelines, has been shown to be the only way to tackle the underdiagnosis mountain. What’s more, NICE recommends that healthcare professionals should have a low threshold for re-testing people if they develop any symptoms consistent with coeliac disease.'

Recent research found that gluten-free product prescribing in primary care dropped from 1.8m prescriptions in 2012/13 to 1.3m in 2016/17.

In March last year, the Department of Health and Social Care ran a public consultation on gluten-free foods, which concluded that prescriptions will be restricted to bread and mixes only.

This change will come into effect from Decemeber this year, following a second consultation to decide which specific products will remain available, and how the changes will be carried out. 

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