SEARCHNARRATIVE_REVIEWgastroenterology, clinical nutrition

narrative_review·gastroenterology, clinical nutrition, nutrition, dietetics, internal medicine·PMC10181343

Follow-Up of Celiac Disease in Adults: “When, What, Who, and Where”

Nutrients · 10 authors, 12 centres

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TL;DR

This narrative review discusses the multidisciplinary management of celiac disease, emphasizing that a lifelong gluten-free diet is the only proven treatment and that follow-up care should aim for mucosal healing and symptom resolution. It concludes that while a structured approach is believed to be optimal, the evidence supporting it remains limited.

Full summary

368 CHARS

It describes CeD as an immune-mediated condition requiring a lifelong gluten-free diet (GFD), with key follow-up endpoints being symptom resolution, normalization of weight, seroconversion, and mucosal healing (Marsh 0–1). The implications are that standardized, evidence-based standards for CeD follow-up care are needed to ensure effective and accessible management.

STUDY TYPE

narrative_review

SPECIALTY

gastroenterology

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100% · A

ORIGINAL PAPER

PMC10181343

Follow-Up of Celiac Disease in Adults: “When, What, Who, and Where”

Nutrients

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ABSTRACT

For patients with celiac disease (CeD), a lifelong gluten-free diet is not a voluntary lifestyle choice—it is a necessity. The key end points in clinical follow-up are symptom resolution, the normalization of weight, prevention of overweight, seroconversion, and negation or minimization of increased long-term morbidity. For the latter, a surrogate endpoint is mucosal healing, which means the normalization of histology to Marsh 0–1. Ideally, celiac follow-up care includes a multidisciplinary approach, effective referral processes, improved access that leverages technological advances, and following guidelines with the identification of measurable quality indicators, ideally informed by evidence-based research. Face-to-face CeD care and telemedicine are considered the standards for this process, although published data are insufficient. Guidelines and statements on diagnosis are readily available. However, data are lacking on optimal clinic visit intervals and outcomes and quality indicators such as improvement of symptoms, function and quality of life, survival and disease control, and how to most effectively use healthcare resources. The results of future research should provide the basis for general recommendations for evidence-based standards of quality of care in CeD.

CITATION EXPORT

Chris J. J. Mulder, Luca Elli, Benjamin Lebwohl et al.. Follow-Up of Celiac Disease in Adults: “When, What, Who, and Where”. Nutrients. (2023). https://doi.org/10.3390/nu15092048

AUTHORS

10 · 12 CENTRES

Chris J. J. Mulder, Luca Elli, Benjamin Lebwohl, Govind K. Makharia, Kamran Rostami, Alberto Rubio-Tapia, Michael Schumann, Jason Tye-Din, Jonas Zeitz, Abdulbaqi Al-Toma

1Department of Gastroenterology, Amsterdam UMC, Location Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
2Center for Prevention and Diagnosis of Celiac Disease, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; [email protected]
3Department of Medicine, Celiac Disease Center, Columbia University Medical Center, 180 Fort Washington Avenue, Suite 936, New York, NY 10032, USA; [email protected]
4Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India; [email protected]
5Department of Gastroenterology, Palmerston North Hospital, Palmerston North 4442, New Zealand; [email protected]
6Division of Gastroenterology, Hepatology, and Nutrition, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH 44195, USA; [email protected]
7Department of Gastroenterology, Infectious Diseases, and Rheumatology, Campus Benjamin Franklin, Charité-University Medicine Berlin, 13125 Berlin, Germany; [email protected]
8Department of Immunology, The Walter and Eliza Hall Institute, Parkville, VIC 3052, Australia; [email protected]
9Department of Gastroenterology, The Royal Melbourne Hospital, Parkville, VIC 3050, Australia
10Division of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; [email protected]
11Swiss Celiac Center, Center of Gastroenterology, Clinic Hirslanden, 8032 Zurich, Switzerland
12Department of Gastroenterology and Hepatology, St. Antonius Hospital, 3435 CM Nieuwegein, The Netherlands; [email protected]

EDITOR / REVIEWER

Giuseppe Chiarioni