Show Notes
In this episode, Dr Julia Rawlinson is joined in this two-part series by Dr Emma Turner, Paediatric Gastroenterologist and Hepatologist at Perth Children’s Hospital, and Dr Erin Horsley, GP Anaesthetist with a special interest in gastroenterology and lived experience parenting a child with coeliac disease.
Providing practical advice for GPs on recognising and investigating coeliac disease in Australian children.
Key points discussed: Prevalence and Risk: Coeliac disease affects about 1 in 70 Australians, with 80% undiagnosed. First-degree relatives have a 10-20% risk depending on family history. Clinical Presentation: Symptoms can include iron deficiency, growth failure, pubertal delay, abdominal pain, and altered bowel habits. Less obvious presentations might be behavioural issues, sleep problems, mild elevation of liver enzymes, dental enamel defects, and recurrent mouth ulcers. Diagnosis should still be considered in children who are growing normally or are obese. Testing Approach: The recommended initial tests are tissue transglutaminase IgA (TTG-IgA) and total IgA. Gluten intake must be adequate for accurate results. There is no current recommendation for population screening, but GPs are encouraged to maintain a low threshold for testing symptomatic children. Diagnosis and Specialist Involvement: Non-biopsy diagnosis can be considered for children with TTG-IgA >10× upper limit of normal plus confirmatory endomysial antibody testing, but all cases require confirmation by a paediatric gastroenterologist. Early gluten-free diets before testing complicate diagnosis and may require a supervised gluten challenge. Screening Relatives and Genetic Testing: All first-degree relatives should be screened, ideally at the time of index case diagnosis, and re-tested every 2–3 years if negative. HLA genetic testing is useful only to exclude coeliac disease, not to confirm it.
Part 2 will focus on managing coeliac disease long term and practical advice for GPs and families.
Links & Resources: https://coeliac.org.au/health-professionals/gluten-challenge/ Health professionals - Coeliac Australia Ongoing management - Coeliac Australia https://coeliac.org.au/health-professionals/ongoing-management/
The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network
If you have any questions or would like to contact The Good GP, send an email to [email protected]. Visit www.thegoodgp.com.au for previous episodes and more information. You can also find us on our Instagram page: @thegoodgppodcast. Follow us for more updates!
More from The Good GP
In this episode of The Good GP, Dr Krystyna de Lange speaks with Dr Steph Daly, GP with a special interest in aged care and dementia, about the introduction of plasma biomarkers, specifically the p-Tau 217 blood test for Alzheimer’s disease. They explore what the p-Tau 217 test measures, its reliability, and its role in primary care.
In this episode of The Good GP, host Dr Krystyna De Lange speaks with Dr David Leitinger, a GP with a special interest in addiction medicine, about the practical use of naltrexone for managing alcohol use disorder (AUD).
In this episode of The Good GP, Dr Julia Rawlinson speaks with Dr Florence Martin, an epidemiologist specialising in pregnancy pharmacoepidemiology. Dr Martin discusses her recent study examining the relationship between first trimester antidepressant use and miscarriage risk, using UK primary care data from the CPRD GOLD database.
In this episode of the Good GP, Dr Julia Rawlinson speaks with Dr Julia Feutrill, consultant psychiatrist at King Edward Memorial Hospital and co-director of the Elizabeth Clinic. They discuss the complexities of antidepressant use during pregnancy, providing GPs with practical advice for navigating these conversations.
In this episode of the Good GP, Dr Julia Rawlinson speaks with Dr Paul Effler, Senior Medical Advisor at the WA Department of Health and expert in communicable diseases, about H5N1 avian influenza and pertussis.