Diagnosis and Management of Celiac Disease
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Guideline title American College of Gastroenterology Guidelines Update: Diagnosis and Management of Celiac Disease
Release date January 2023
Prior version May 2013
Developer and funding source American College of Gastroenterology
Target population Children and adults with celiac disease
Selected recommendations
Screening for celiac disease in asymptomatic people in the general population is not recommended (strong recommendation; low quality of evidence).
Upper endoscopy with multiple (≥4) duodenal biopsies is recommended for diagnostic confirmation in both children and adults who have characteristic signs and symptoms of celiac disease (strong recommendation; moderate quality of evidence).
In symptomatic children, a blood test with high-level tissue transglutaminase antibody (tTG) IgA (>10 times the upper limit of normal) and presence of endomysial antibody (EMA) in a second blood sample are suggested for diagnosis of celiac disease. In symptomatic adults who are unwilling or unable to undergo upper endoscopy, high-level tTG IgA and presence of EMA can be used to establish a diagnosis of likely celiac disease (conditional recommendation; moderate quality of evidence).
A gluten-free diet is required (strong recommendation; moderate quality of evidence) to achieve the treatment goal of resolution of histologic mucosal lesions in adults (conditional recommendation; low quality of evidence).
