Why have the guidelines been updated?
The previous BSG guidelines were last published in 2014. Since then, there have been significant steps forward in our understanding of the condition and advancements in current diagnostic technologies and clinical practice.
The guidance has been shaped by a multidisciplinary team of international experts, including clinicians, dietitians, patient representatives, and representatives from Coeliac UK.
The updated guidelines will further support healthcare professionals to recognise the spectrum of coeliac disease presentations and navigate the appropriate diagnosis pathways and reporting for IgA deficient, potential, ultra short, seronegative, non-responsive and refractory coeliac disease.
What will the changes mean?
The first line test for coeliac disease is a simple blood test which checks for the presence of disease specific antibodies, in response to eating gluten. Anyone with a positive test should be referred to gastroenterology or coeliac service for a joint decision in discussion with the patient, whether an endoscopy and biopsy are required.
The new guidelines formally recognise that, in secondary care settings, some symptomatic adults may be diagnosed with a blood test without a confirmatory endoscopy and biopsy. Advancements like this could significantly accelerate diagnosis for patients and reduce pressure on NHS services.
These guidelines also emphasise the key role of the specialist dietitian, the need for regular follow up in the first two years and a discussion between patient and clinician on support after this point, including guidance on facilitating easy access to patient initiated follow up as required.
Anyone being tested for coeliac disease should continue eating gluten until all investigations have been completed, as diagnostic tests rely on detecting the body’s immune response to gluten.
Heidi Urwin, Director of Evidence and Policy at Coeliac UK who was involved in the development of the guidelines, explains what the new guidelines will mean:
“It’s great to see the revised guidelines opening up new routes to diagnosis, for the spectrum of presentations in adult coeliac disease and encouraging discussions between patient and clinician in decision making.”
“The guidelines outline the need to identify those patients who may be at risk and require long term ongoing support, and facilitating easy access to care for those that are doing well, should things change and they again need help. Ultimately the right care, at the right time for adults with coeliac disease”
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You can find out more about or read more about the guidelines in our FAQs.
We will be updating our information in line with the new guidelines over the next couple of weeks, but please bear in mind that while this is happening, some of our information may not yet reflect these changes.