Endoscopic features of coeliac disease

Gastrointestinal endoscopy is not the first line diagnostic tool in coeliac disease. However, awareness of its basic endoscopic features may alert endoscopists to the presence of the disease. Endoscopic features of coeli- ac disease comprise reduction in the number or loss of folds, mosaic appearance, scalloping, fissures or grooves of folds in the jejunum, and visible vascular pattern (in the duodenum) and (micro-) nodularity. Loss of intestinal villi can be set off with the immersion technique. Chromoendoscopy using indigo carmine or methylene blue can enhance the mosaic pattern of intestinal mucosa. Push-enteroscopy and/or capsule endoscopy is important in the follow-up and diagnostics of complications of coeliac disease (refractory sprue, ulcerative jejunoileitis and T-cell lymphoma).