We very excited about the episode today!

We are joined by A/Professor Jason Tye-Din - a leading expert in coeliac disease and immune-mediated gut disorders. He is Coeliac labratory head at the Walter and Eliza Hall Institute of Medical Research, a Mathison Centenary Fellow at the University of Melbourne, and consultant Gastroenterologist at the Royal Melbourne Hospital. His work focuses on the immunology of coeliac disease, novel diagnostic approaches, and developing non-dietary treatments. He is also one of the smartest (and nicest) clinicians that we have had the privilege of working with.

Joining Jason on the podcast today is Dr Cynthia Kanagasundaram. Cynthia is a UK trained Consultant Gastroenterologist with a vast experience in all things gastroenterology. She prides herself on innovation and has developed a novel GUT HUT service which slashed waiting times and improved patient care. She is embarking on a new stage of her career exploring novel diagnostics, techniques and treatments in Coeliac disease in the Tye-Din lab at the WEHI with A/Prof Jason Tye-Din as her supervisor.

Today we delve into the complexities of coeliac disease. We cover the diagnosis, dietary management, refractory celiac disease, models of care and future of coeliac.

The International Celiac Disease Symposium (ICDS 2026) will be held in Melbourne Australia 17-20 November 2026. Details at https://www.icds2026.org

Chapters

00:20 Introduction with Jon and James

04:42 Introduction to A/Prof Tye-Din and Dr Kanagasundaram

06:42 Understanding Coeliac Disease: Diagnosis and Patient Education

09:17 Dietary Considerations: Foods to Avoid and Oats Discussion

12:44 Biopsy Guidelines and Diagnostic Approaches

16:44 Revisiting Biopsy Techniques and Clinical Observations

19:40 Mucosal Healing and Follow-Up Practices

22:35 Refractory Coeliac Disease: Definitions and Management

26:48 Treatment Strategies for Refractory Coeliac Disease

31:14 Understanding Treatment Targets in Coeliac Disease

32:16 Maintenance Treatment for Refractory Coeliac Disease

33:13 Exploring Alternative Treatment Options

34:12 Balancing Treatment Risks and Benefits

34:59 Advancements in Histology and Scoring Systems

37:05 Future Directions in Coeliac Disease Research

39:01 Innovations in Diagnosis and Screening

41:01 The Role of Gluten Challenges in Diagnosis

43:14 Understanding the Causes of Coeliac Disease

45:14 Patient Management and Follow-Up Care

48:12 Vaccination and Hyposplenism

56:13 Opportunities for Research and Collaboration

Links to papers mentioned

Iron deficiency.(Link)

2020 ESPGHAN Guidelines for diagnosing Coeliac Disease

Clinical and Immunologic Features of Ultra-Short Celiac Disease. (Link)

A prospective, double-blind, placebo-controlled trial to establish a safe gluten threshold for patients with celiac disease.(Link)

Diagnostic outcomes after gluten challenge in adult patients with unconfirmed coeliac disease already on a gluten-free diet: A 20-year retrospective cohort study.(Link)

AGA Clinical Practice Update on Management of Refractory Celiac Disease: Expert Review. (Link)

Open-Capsule Budesonide for Refractory Celiac Disease. (Link)

Budesonide Induces Favourable Histologic and Symptomatic Recovery in Patients with Non-responsive and Refractory Coeliac Disease When Given in an Open Capsule Format. (Link)

Stool Gluten Peptide Detection Is Superior to Urinary Analysis, Coeliac Serology, Dietary Adherence Scores and Symptoms in the Detection of Intermittent Gluten Exposure in Coeliac Disease: A Randomised, Placebo-Controlled, Low-Dose Gluten Challenge Study. https://doi.org/10.3390/nu16020279

Impaired IgM Memory B Cell Function Is Common in Coeliac Disease but Conjugate Pneumococcal Vaccination Induces Robust Protective Immunity. (Link)