NICE Nuggets NG20 Coeliac disease: Recognition, assessment and management

摘要

Recognition of coeliac disease The guideline recommends offering serological testing for coeliac disease to people with symptoms of coeliac disease, including those with persistent unexplained abdominal symptoms, faltering growth, prolonged fatigue, unexpected weight loss, severe or persistent mouth ulcers, or unexplained iron, vitamin B12 or folate deficiency. Serological testing should also be offered to those at increased risk of having coeliac disease, including those who meet the diagnostic criteria for irritable bowel syndrome (IBS), those diagnosed with type 1 diabetes or autoimmune thyroid disease and first-degree relatives of people with coeliac disease. In other symptoms and conditions, such as subfertility, raised liver enzymes and peripheral neuropathy, NICE recommends considering serological testing for coeliac disease. If serological testing is offered, NICE recommends explaining to people the importance of continuing a gluten-containing diet during testing, advising them to eat some gluten in more than one meal every clay for at least 6 weeks before testing.