GIG’s 5 Key Takeaways from the American College of Gastroenterology’s Updated Medical Guidelines for Diagnosis and Management of Celiac Disease

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In January 2023, the American College of Gastroenterology updated its guidelines so that medical professionals have the most up-to-date information on diagnosing and managing celiac disease in their patients. While these guidelines are for doctors, we’ve highlighted our five key takeaways that you may find valuable. 

 

#1 Blood test plus biopsies remain the gold standard, but a diagnosis may be made based on blood tests alone. 

Detecting celiac disease through blood tests and intestinal biopsies has long been considered the best way to find celiac disease.

  • The guidelines recommend an endoscopy with multiple upper small intestine biopsies to confirm celiac disease in children and adults.
  • The guidelines now suggest a combination of blood tests is reliable for a celiac disease diagnosis in children. 
  • In symptomatic adults unwilling or unable to undergo an upper GI endoscopy, the same criteria may be considered as a diagnosis of likely celiac disease.

 

#2 Don’t monitor your diet with a gluten-detecting device.

  • The guidelines suggest against routine use of gluten detection devices for food, stool, or urine.
  • The authors note that the technologies may not distinguish between significant and trivial gluten exposure.

 

#3 The jury is out on the use of probiotics. 

  • The guidelines state there is insufficient evidence about using probiotics to treat celiac disease.

 

#4 Oats are in, if they are gluten-free.

  • The recommendation is to include gluten-free oats in the diet of those with celiac disease, including newly diagnosed patients.
  • The authors note that monitoring for oat tolerance should be considered as there is a small risk of an immune reaction to the oat protein avenin.

 

#5 The general population won’t be screened for celiac disease anytime soon, but plenty of individuals should be.

  • The guidelines DO NOT recommend mass screening for celiac disease.
  • The guidelines DO recommend screening based on case findings that include the following criteria:
    • People with symptoms, signs, or lab results suggesting the body is not absorbing nutrients.
    • People with symptoms, signs, or lab results indicative of celiac disease.
    • First-degree family members of someone with celiac disease, regardless of whether they show signs, symptoms, or have suggestive lab results.
      • Other relatives should be considered for celiac screening.

An extensive amount of information is covered in this medical update. If you would like to read the guidelines, click here.