The American Journal of Gastroenterology published an update to the 2013 American College of Gastroenterology Guideline on the Diagnosis and Management of Celiac Disease with updated recommendations for the evaluation and management of patients with celiac disease (CD).
An expert panel created updated recommendations, which include the following:
- EGD with multiple biopsies of the duodenum are necessary for CD diagnosis in adults and children.
- A combination of TTG-IgA >10X normal and + EMA on a second sample for diagnosis of CD in children.
- The goal of intestinal healing as the endpoint of treatment.
- Suggest against the routine use of gluten detection devices among patients with CD.
- Insufficient evidence to recommend for or against the use of probiotics.
- Although consumption of oats seems safe for most patients with CD, a subset of patients may be immunogenic.
- Vaccinate to prevent pneumococcal disease.
- Recommend for case finding of CD and against mass screening.
- Anti-TTGA-IgA is the preferred single test for children < 2 years that are not IgA deficient.
The publication, with additional recommendations, can be read here.
Rubio-Tapia, Alberto MD1; Hill, Ivor D. MD2; Semrad, Carol MD3; Kelly, Ciarán P. MD4; Lebwohl, Benjamin MD, MS5. American College of Gastroenterology Guidelines Update: Diagnosis and Management of Celiac Disease. The American Journal of Gastroenterology 118(1):p 59-76, January 2023. | DOI: 10.14309/ajg.0000000000002075
