It is suggested that there should be the initial consultation with you, the GP, once the diagnosis is made and the appropriate referrals especially to the dietitians and to Coeliac New Zealand arranged. Then, it is suggested you see them again about 3 months later to ensure that the patient is going well with the gluten free diet and symptoms improving.

In general, once a gluten free diet is started, symptomatic improvement occurs within the first week.

Thereafter, they could be seen yearly, unless symptoms persist or recur. Repeat testing with coeliac serology should be arranged at the first yearly visit. It can take up to 12-18 months for coeliac serology results to completely return to normal. A further biopsy is not needed.
Patients who are iron deficient may need iron supplementation and repeat iron studies done earlier if indicated.

In general, no. The paediatric gastroenterologists can answer questions from GPs via the e-referrals request for information form. If there is an urgent medical problem, please phone the general paediatric medicine registrar on call at your DHB.

Please note that most patients with suspected coeliac disease can be referred by GPs or general paediatriciansdirectly for endoscopy, and do not require urgent admission. Occasionally, some patients, especially those of toddler age, can present with significant malnutrition (weight loss, abdominal distension, steatorrhoea). These should be discussed with the paediatric gastroenterology service, so that a small bowel biopsy can be performed in a timely fashion.

The menu also helps if you need to take into consideration a nut free diet by coding dishes nut free (NF). Some recipes can also be adapted to be NF.