Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology

Jonas F Ludvigsson; Julio C Bai; Federico Biagi; Timothy R Card; Carolina Ciacci; Paul J Ciclitira; Peter H R Green; Marios Hadjivassiliou; Anne Holdoway; David A van Heel; Katri Kaukinen; Daniel A Leffler; Jonathan N Leonard; Knut E A Lundin; Norma McGough; Mike Davidson; Joseph A Murray; Gillian L Swift; Marjorie M Walker; Fabiana Zingone; David S Sanders; BSG Coeliac Disease Guidelines Development Group; British Society of Gastroenterology

doi:10.1136/gutjnl-2013-306578

Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology

Gut. 2014 Aug;63(8):1210-28. doi: 10.1136/gutjnl-2013-306578. Epub 2014 Jun 10.

Authors

Jonas F Ludvigsson¹, Julio C Bai², Federico Biagi³, Timothy R Card⁴, Carolina Ciacci⁵, Paul J Ciclitira⁶, Peter H R Green⁷, Marios Hadjivassiliou⁸, Anne Holdoway⁹, David A van Heel¹⁰, Katri Kaukinen¹¹, Daniel A Leffler¹², Jonathan N Leonard¹³, Knut E A Lundin¹⁴, Norma McGough¹⁵, Mike Davidson¹⁶, Joseph A Murray¹⁷, Gillian L Swift¹⁸, Marjorie M Walker¹⁹, Fabiana Zingone⁵, David S Sanders²⁰; BSG Coeliac Disease Guidelines Development Group; British Society of Gastroenterology

Affiliations

¹ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Department of Paediatrics, Örebro University Hospital, Örebro, Sweden.
² Department of Medicine, Dr C. Bonorino Udaondo Gastroenterology Hospital, Del Salvador University, Buenos Aires, Argentina.
³ Coeliac Centre/1st Department of Internal Medicine, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
⁴ University of Nottingham, Department of Epidemiology and Public Health, Nottingham City Hospital, Nottingham, UK.
⁵ Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
⁶ Gastroenterology, Division of Nutritional Sciences, King's College London, The Rayne Institute, St Thomas Hospital, London, UK.
⁷ Coeliac Disease Center at Columbia University, New York, New York, USA.
⁸ Department of Neurology, Royal Hallamshire Hospital, Sheffield, UK.
⁹ Registered dietitian and representative of the British Dietetic Association, Bath, Somerset, UK.
¹⁰ Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
¹¹ School of Medicine, University of Tampere, Tampere, Finland Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland Department of Medicine, Seinäjoki Central Hospital, Finland.
¹² Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
¹³ Department of Dermatology, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK.
¹⁴ Department of Gastroenterology, Centre for Immune Regulation, Oslo University Hospital Rikshospitalet, Oslo, Norway.
¹⁵ Coeliac UK, Apollo Centre, London, UK.
¹⁶ Patient Representative & Regional Chairman for Coeliac UK, Sheffield, UK.
¹⁷ Division of Gastroenterology and Hepatology, Department of Immunology Mayo Clinic, Rochester, Minnesota, USA.
¹⁸ Department of Gastroenterology, University Hospital Llandough, Wales, UK.
¹⁹ Anatomical Pathology, University of Newcastle, Faculty of Health and Medicine, School of Medicine & Public Health, Callaghan, Australia.
²⁰ Gastroenterology and Liver Unit, Royal Hallamshire Hospital & University of Sheffield, Sheffield, UK.

Abstract

A multidisciplinary panel of 18 physicians and 3 non-physicians from eight countries (Sweden, UK, Argentina, Australia, Italy, Finland, Norway and the USA) reviewed the literature on diagnosis and management of adult coeliac disease (CD). This paper presents the recommendations of the British Society of Gastroenterology. Areas of controversies were explored through phone meetings and web surveys. Nine working groups examined the following areas of CD diagnosis and management: classification of CD; genetics and immunology; diagnostics; serology and endoscopy; follow-up; gluten-free diet; refractory CD and malignancies; quality of life; novel treatments; patient support; and screening for CD.

Keywords: Coeliac Disease; Gluten; Gluten Free Diet; Small Bowel Disease.

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Publication types

Practice Guideline
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Biopsy
Celiac Disease / diagnosis*
Celiac Disease / diet therapy*
Celiac Disease / pathology
Diet, Gluten-Free*
Duodenum / pathology*
Endoscopy, Gastrointestinal
GTP-Binding Proteins
Gliadin / immunology
Histocompatibility Testing
Humans
Immunoglobulin A / blood*
Protein Glutamine gamma Glutamyltransferase 2
Transglutaminases / immunology

Substances

Immunoglobulin A
Gliadin
Protein Glutamine gamma Glutamyltransferase 2
Transglutaminases
GTP-Binding Proteins

Grants and funding

R01 DK057892/DK/NIDDK NIH HHS/United States