Coeliac disease
Meaning of coeliac disease: For the purposes of this Statement of Principles, coeliac disease: (a) means a malabsorption disorder in susceptible people due to immune-mediated mucosal inflammation of the small intestine, characterised by villous atrophy and crypt hyperplasia, and triggered by hypersensitivity to ingested gluten; and (b) excludes: (i) non-coeliac gluten sensitivity; (ii) non-coeliac wheat protein sensitivity; and (iii) wheat allergy.
Reasonable Hypothesis (RH) — Statement of Principles No. 29 of 2020
At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting coeliac disease or death from coeliac disease with the circumstances of a person's relevant service:
- (1)being treated with interferon alpha within the six months before the clinical worsening of coeliac disease;
- (2)being treated with ribavirin within the six months before the clinical worsening of coeliac disease;
- (3)being treated with a proton pump inhibitor or a histamine-2 receptor antagonist, on more days than not, for at least the six months before the clinical worsening of coeliac disease;
Note: Examples of proton pump inhibitors include esomeprazole, lansoprazole, omeprazole, pantoprazole and rabeprazole.
Note: Examples of histamine-2 receptor antagonists include cimetidine, famotidine, nizatidine and ranitidine.
- (4)being treated with a non-selective, non-steroidal, anti-inflammatory agent, on more days than not, for at least the six months before the clinical worsening of coeliac disease;
Note: Examples of non-selective, non-steroidal, anti-inflammatory agents include aspirin, diclofenac, ibuprofen, indomethacin, ketoprofen, ketorolac, mefenamic acid, naproxen, piroxicam and sulindac.
- (5)inability to maintain a gluten-free diet at the time of the clinical worsening of coeliac disease;
- (6)inability to obtain appropriate clinical management for coeliac disease;
Aggravation-only factors: the factors in subsections 9(1) to 9(6) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
Balance of Probabilities (BoP) — Statement of Principles No. 30 of 2020
4 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, coeliac disease or death from coeliac disease is connected with the circumstances of a person's relevant service:
- (1)being treated with interferon alpha within the six months before the clinical worsening of coeliac disease;
- (2)being treated with a proton pump inhibitor or a histamine-2 receptor antagonist, on more days than not, for at least the six months before the clinical worsening of coeliac disease;
Note: Examples of proton pump inhibitors include esomeprazole, lansoprazole, omeprazole, pantoprazole and rabeprazole.
Note: Examples of histamine-2 receptor antagonists include cimetidine, famotidine, nizatidine and ranitidine.
- (3)inability to maintain a gluten-free diet at the time of the clinical worsening of coeliac disease;
- (4)inability to obtain appropriate clinical management for coeliac disease;
Aggravation-only factors: the factors in subsections 9(1) to 9(4) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
