How to approach, support and encourage coeliac testing

Testing for coeliac disease isn’t always the first port of call when we start feeling unwell. Men especially are less likely to seek medical attention when experiencing signs and symptoms such as nausea, fatigue and weight loss.

 If you suspect a male in your family may be suffering at the hands of gluten, encouraging them to get tested can mean positive change all round. However, initiating conversation and discussing testing isn’t always easy – for both parties involved. Here we share a few reasons why males should prioritise a test, why they may be reluctant to and tips on how to approach a loved one who may need help.

 Why get tested?

• Men may present with coeliac symptoms without drawing a link between ill health and their diet. Coeliac disease can act sinisterly amongst those who are more likely to overlook subtle signs including: gradual weight loss, digestive discomfort, irregular bowel habits and generalised fatigue.
• A diagnosis might not be made until symptoms clinically manifest as anaemia, multiple nutritional deficiencies, low weight-to-height ratio and raised liver enzymes.
• Generally, the prevalence of coeliac disease is similar between both genders. However, a higher prevalence among women on some accounts might be because of lack of recognition and under diagnosis in men.
• Recent Australian statistics have shown coeliac disease occurs in 1.2% (1:86) of adult men and 1.9% in adult women.
• Going undiagnosed can increase a person’s risk of inflammatory and hormonal manifestations including: bone loss, arthritis, skin conditions, gum disease, tooth decay and psychological manifestations such as anxiety and depression.

 Why are males more likely to ignore signs and symptoms?

• Some men are programmed not to show emotion or complain about having a stomach ache or the like. Many might feel it’s easier to ignore it than acknowledge it.
• Those that are avoiding a test may be concerned that a positive result will have implications they can’t manage. Coeliac disease has a strong genetic component and some worry it’ll also affect others in the family – namely undiagnosed children.
• Diagnosis with coeliac disease means lifelong change, which generally comes with psychosocial implications. Social anxiety and a sense of burden bought on by following a strict gluten free diet are less talked about, and not as well understood by the wider population.

How to approach your loved one about getting tested:

• Begin a conversation when you are both in a comfortable setting – relaxed and calm.
• Plan the conversation when you are both focused and free of distractions. Aim to speak person-to-person and keep the conversation open – it shouldn’t be a one-sided talk.
• Discuss the symptoms of coeliac disease – explaining that many people present different symptoms and some people have none at all. There is no ‘one symptom fits all’ group.
• If you feel the conversation is progressing well, you can also broach the topic of more serious coeliac disease implications such as: osteoporosis, arthritis, pancreatitis, anxiety/depression, and risk of developing other autoimmune conditions such as type 1 diabetes and hypothyroidism.
• Before you finish talking, aim to set up a time to revisit the conversation. Ask them when suits to have another chat? Would they like you to make a doctor’s appointment, or suggest they complete the CNZ Online Self-Assessment which provides a letter to discuss with their GP about getting tested.