Coeliac Disease
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If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.
- No emergency indicators identified; routine prioritisation applies
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- Refer to HealthPathways for assessment and management recommendations.
- Consider the following:
- Referral to Dietitian:
- do not remove gluten prior to diagnostic testing or endoscopy, as this may affect results.
- once diagnosis is confirmed, refer the patient to a dietitian experienced in gastrointestinal/coeliac disease management for:
- education on a strict gluten-free diet
- ongoing monitoring of adherence and nutritional adequacy
- individualised education should be provided if there are concerns regarding adherence or nutritional management.
- Referral to Dietitian:
- Screen family members with serology (1 in 10 chance in immediate family members)
- Baseline bone mineral densitometry in all adults (those with medically diagnosed coeliac disease are entitled to a Medicare rebate).
- Monitor for other auto-immune disorders
- Expanded nutrient testing e.g. magnesium, zinc, calcium and copper are not routine but should be considered if malabsorption is suspected.
- Immunisations:
- Annual influenza, COVID-19 and against pneumococcus is recommended.
- Vaccination against the other main encapsulated bacteria Neisseria meningitidis and Haemophilus influenzae type B should be considered
Note: If the patient is already following a gluten-free diet, advise that a gluten challenge may be required prior to diagnostic testing (typically 8–10 g of gluten per day for 6 weeks). If the patient is not on a gluten-free diet, recommend avoiding dietary changes until diagnostic confirmation has been completed.
| Category 1 (appointment within 30 calendar days) |
Note:Referrals for conditions such as coeliac disease should be directed through the most clinically appropriate pathway. This may include a complementary care pathway, a Dietitian First gastroenterology clinic pathway. The triage process should be guided by the patient’s predominant clinical features, the suspected underlying cause, and the investigations or interventions most likely to be required. In some Hospital and Health Services (HHSs), patients may be considered for an initial assessment by a Dietitian, either before or instead of being referred to Gastroenterology. This approach supports appropriate and timely referrals to the most suitable pathway, ensuring patients receive the care that best addresses their specific needs. |
| Category 2 (appointment within 90 calendar days) |
Note: Referrals for conditions such as coeliac disease should be directed through the most clinically appropriate pathway. This may include a complementary care pathway, a Dietitian First gastroenterology clinic pathway. The triage process should be guided by the patient’s predominant clinical features, the suspected underlying cause, and the investigations or interventions most likely to be required. In some Hospital and Health Services (HHSs), patients may be considered for an initial assessment by a Dietitian, either before or instead of being referred to Gastroenterology. This approach supports appropriate and timely referrals to the most suitable pathway, ensuring patients receive the care that best addresses their specific needs |
| Category 3 (appointment within 365 calendar days) |
Note: Referrals for conditions such as coeliac disease should be directed through the most clinically appropriate pathway. This may include a complementary care pathway, a Dietitian First gastroenterology clinic pathway. The triage process should be guided by the patient’s predominant clinical features, the suspected underlying cause, and the investigations or interventions most likely to be required. In some Hospital and Health Services (HHSs), patients may be considered for an initial assessment by a Dietitian, either before or instead of being referred to Gastroenterology. This approach supports appropriate and timely referrals to the most suitable pathway, ensuring patients receive the care that best addresses their specific needs |
Please insert the below information and minimum referral criteria into referral
1. Reason for request Indicate on the referral
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can't order, or the patient can't afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
2. Essential referral information Referral will be returned without this
- FBC, ELFT, iron studies
- Previously positive serology results or biopsy results (if applicable).
- Transglutaminase-IgA (tTG-IgA) antibody test AND the total IgA level (to exclude the 2-3% of people with coeliac disease who are IgA deficient).
3. Additional referral information Useful for processing the referral
- HLA DQ2 and HLA DQ8 genetic testing if serology negative/inconclusive and patient unable to or reluctant to complete gluten challenge*.
- TSH, Vitamin B12, Folate, Vitamin D
- Bone mineral density scan results
*Genetic testing investigations provide valuable diagnostic information but may not be covered by Medicare and could incur an out-of-pocket cost to the patient. These tests are recommended where clinically appropriate; however, completion should be based on informed patient choice following discussion with the referring clinician.
4. Request
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Patient's Demographic Details
- Full name (including aliases)
- Date of birth
- Residential and postal address
- Telephone contact number/s – home, mobile and alternative
- Medicare number (where eligible)
- Name of the parent or caregiver (if appropriate)
- Preferred language and interpreter requirements
- Identifies as Aboriginal and/or Torres Strait Islander
Referring Practitioner Details
- Full name
- Full address
- Contact details – telephone, fax, email
- Provider number
- Date of referral
- Signature
Relevant clinical information about the condition
- Presenting symptoms (evolution and duration)
- Physical findings
- Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
- Body mass index (BMI)
- Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
- Current medications and dosages
- Drug allergies
- Alcohol, tobacco and other drugs use
Reason for request
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can't order, or the patient can't afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
Clinical modifiers
- Impact on employment
- Impact on education
- Impact on home
- Impact on activities of daily living
- Impact on ability to care for others
- Impact on personal frailty or safety
- Identifies as Aboriginal and/or Torres Strait Islander
Other relevant information
- Willingness to have surgery (where surgery is a likely intervention)
- Choice to be treated as a public or private patient
- Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
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If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.
Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.
Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.
Last updated: 29 September 2026
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