Published online Jan 7, 2022. doi: 10.3748/wjg.v28.i1.154
Peer-review started: March 2, 2021
First decision: July 14, 2021
Revised: August 8, 2021
Accepted: December 25, 2021
Article in press: December 25, 2021
Published online: January 7, 2022
Processing time: 303 Days and 16.8 Hours
Celiac disease (CD) has risen from obscurity to global prominence in a few decades. These modifications have prompted experts from all over the world to identify effective strategies for the diagnosis and follow-up of CD. Different scientific societies, mainly from Europe and America regions, have proposed different guidelines.
CD guidelines are consistent when they deal key points in the diagnosis and follow-up of this condition. However, they differ in a number of other points.
To identify all of the existing guidelines across the globe and perform a comparative analysis to verify similarities and differences and, thus, discuss the most debated topics and the possible innovations in the next future.
We searched PubMed for a complex string containing the terms “celiac disease”, “management”, and “guidelines”. The results were subsequently explored to identify the most recent versions of existing guidelines of governmental agencies and scientific societies. The recommendations provided by each selected guideline were systematically explored and classified under five categories: Patients to be tested for CD, diagnostic tests (serology, duodenal biopsy, genetic test, no-biopsy diagnosis), potential/silent/seronegative CD, refractory/complicated CD, follow-up.
We identified 7 different guidelines [European Society Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) 2020; European Society for the Study of Coeliac Disease (ECD) 2019; World Gastroenterology Organization (WGO) 2017; Central Research Institute of Gastroenterology, Russia, 2016; National Institute for Health and Care Excellence (NICE), 2015; British Society of Gastroenterology (BSG), 2014; and America College of Gastroenterology (ACG), 2013]. These guidelines were mostly concordant but differed under certain recommendation for no-biopsy diag
We found a relatively high concordance between the guidelines for CD. Important modifications have occurred in the last years, especially about the possibility of a no-biopsy diagnosis in children.
Modifications of the current guidelines are expected in the near future. These modification will probably regard the possibility of a no-biopsy diagnosis (especially in developing countries) and the modalities of follow-up.