Coeliac disease, previously regarded as unusual and florid, is now see
n as having an extraordinary breadth of manifestations. Many cases are
unrecognised or latent. Diarrhoea and abdominal complaints may be pre
sent in low key but chronic ill health; anaemia, endocrine and neurolo
gical changes are increasingly recognised. Suspicion should lead strai
ght to serological tests, of which the antiendomysial antibody test is
best. If suspicion is high, endoscopic duodenal biopsy is mandatory.
A gluten free diet, while difficult to maintain, effectively cures and
prevents complications.