The American College of Gastroenterology has updated its guidelines for the diagnosis and management of celiac disease, bringing current the recommendations outlined in 2013. Celiac Disease Foundation Research Grant Recipient Dr. Benjamin Lebwohl lent his expertise to the team of researchers led by the Cleveland Clinic’s Dr. Alberto Rubio-Tapia in revising the clinical guidelines for 2023.

“A precise celiac disease diagnosis is just the beginning of the role of the gastroenterologist,” Dr. Rubio-Tapia said in this Medscape article. “But most importantly, we need to take care of our patients’ needs with good goal-directed follow-up…with experienced dietitians playing an important role.”

The following eight recommendations are outlined in this summary:

  • Using upper gastrointestinal endoscopy with multiple duodenal biopsies for confirming the presence of the disease in both children and adults.
  • Noting that the endpoint of gluten-free diet therapy is intestinal healing and clinicians should create individualized goals for each of their patients.
  • Staying away from gluten detection devices in food or biospecimens.
  • Remarking on the fact that the use of probiotics for patients with CD lacks sufficient evidence to strongly recommend its use.
  • Including gluten-free oats as part of one’s diet for those with CD.
  • Receiving the pneumococcal vaccine to prevent infection in those with CD.
  • Using case finding to increase detection of CD in clinical practice. The use of mass screening for CD in the community is not recommended.
  • For patients aged 2 years and younger, immunoglobulin IgA anti-TTG is the preferred single test for CD detection, and testing for CD in children with IgA should be performed using IgG-based antibodies.

For further information, read the complete journal article here.

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