Introduction

This guideline relates to coeliac disease in paediatric patients. For more information please see: Clinical Practice Guidelines: Abdominal pain - acute or Clinical Practice Guidelines: Abdominal pain - chronic.

When to refer

• Patients aged 0-16 years
• Suspected coeliac disease with any of the following:
  • Tissue transglutaminase IgA (TTG IgA) 2-10 (semi-urgent) or > 10 (urgent) x upper limit normal (ULN)
  • Iron deficiency anaemia
  • Faltering growth (weight loss of > 2 weight centiles)
  • Suspected coeliac disease in the presence of IgA deficiency (< 0.2 g/L)
• Patients with coeliac disease who are difficult to control with ongoing symptoms despite strict gluten free diet for more than 12 months

Services available closer to home

Other hospitals with public paediatric general medicine/gastroenterology services include:

• Austin Hospital
• Box Hill Hospital (Eastern Health)
• Monash Medical Centre
• The Northern Hospital
• Sunshine Hospital (Western Health)

Referral criteria/required information

• Detailed history and assessment, including duration of symptoms
• Family history of coeliac disease and/or autoimmune disease
• Provisional diagnosis and current management to date  
• Growth charts: including current weight, weight loss (amount and timeframe)
• Blood tests:
  • Full blood count (FBC)
  • Iron studies
  • Endomysial antibodies IgA or deamidated gliadin antibodies IgG
• Tissue transglutaminase IgA (TTG IgA) on gluten-containing diet for > 6 weeks
• Total IgA

Note: continue gluten-containing diet until initial review or withdraw gluten and advise patient that reintroduction of gluten may be required for further testing.  

How to refer

RCH Specialist Clinics Referral.pdf

Please complete the above and submit via:

• Fax (03) 9345 5034 or
• Email screferrals@rch.org.au
• Urgent referral or clinical query call ED admitting officer (52171) or Gastroenterology Outpatient Consult Fellow on (03) 9345 5522. If after hours ask for Gastroenterology fellow on call

Information for families

Kids Health Info : Abdominal pain

Resources and links

• Clinical Practice Guidelines : Abdominal pain - acute
• Clinical Practice Guidelines : Abdominal pain - chronic

Acknowledgements

The development of this guideline was coordinated by the Department of Gastroenterology (A/Prof. George Alex). Guideline reviewed in July 2025.