Celiac Disease Clinical Practice Guidelines (ACG, 2023)

American College of Gastroenterology

These are some of the highlights of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.

March 02, 2023

Guidelines for the diagnosis and management of celiac disease were published in January 2023 by the American College of Gastroenterology (ACG) in the American Journal of Gastroenterology.[1]

Esophagogastroduodenoscopy (EGD) with multiple duodenal biopsies is recommended for confirmation of diagnosis in both children and adults suspected to have celiac disease (CD).

Combination of high-level tissue transglutaminase (TTG) IgA (>10× upper limit of normal) with a positive endomysial antibody (EMA) in a second blood sample is a reliable test for diagnosing CD in children.

Intestinal healing is recommended as the goal of gluten-free diet (GFD) therapy in CD patients.

Use of gluten detection devices in food or biospecimens among patients with CD is not recommended.

Consumption of gluten-free oats in the diet of those with CD is recommended.

Vaccination to prevent pneumococcal disease is recommended in patients with CD.

Immunoglobulin IgA anti-TTG antibody (TTG-IgA) is the preferred single test for the detection of CD in children younger than 2 years who are not IgA-deficient.

Testing for CD in children with IgA deficiency should be performed using IgG-based antibodies.


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