This document presents official recommendations from the American College of Gastroenterology (ACG) on the diagnosis, management, and follow-up of celiac disease (CD) in children and adults. This guideline was developed in compliance with the Institute of Medicine standards for practice guidelines and uses the Grading of Recommendation Assessment Development and Evaluation (GRADE) approach. The primary objective is to produce high-quality evidence-based clinical practice guidelines to answer common clinical questions and improve health care.
The guideline evaluates a broad spectrum of clinical practice, including indication for CD testing; diagnostic strategies for individuals on a gluten-containing diet or following a gluten-free diet (GFD); role of biopsy for confirmation of the diagnosis; indication for gluten challenge and genetic testing; general approach to management; preventive care such as vaccination; monitoring of GFD adherence including discussion of gluten detection devices, probiotics, goals of therapy, and outcomes; and the differential diagnosis for nonresponsive CD.
The guideline developers from ACG identified key questions that providers face frequently in the diagnosis, management, and follow-up of patients with CD (Tables 1 and 2). This guideline is intended for healthcare providers who care for patients with CD.