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Brief Summary

GUIDELINE TITLE

Celiac disease.

BIBLIOGRAPHIC SOURCE(S)

  • National Institutes of Health (NIH) Consensus Development Panel on Celiac Disease. Celiac disease. Bethesda (MD): U.S. Department of Health and Human Services (DHHS); 2004 Aug 9. 15 p.

GUIDELINE STATUS

This is the current release of the guideline.

BRIEF SUMMARY CONTENT

 
RECOMMENDATIONS
 EVIDENCE SUPPORTING THE RECOMMENDATIONS
 IDENTIFYING INFORMATION AND AVAILABILITY
 DISCLAIMER

 Go to the Complete Summary

RECOMMENDATIONS

MAJOR RECOMMENDATIONS

Conclusions

Celiac disease is an immune-mediated intestinal disorder with protean manifestations. Celiac disease is common, affecting 0.5 to 1.0 percent of the general population of the United States, but is greatly underdiagnosed. There are now specific and sensitive serologic tests available to aid in diagnosis that need to be more widely applied. The treatment of celiac disease remains a lifelong gluten-free diet, which results in remission for most individuals. The classic presentation of diarrhea and malabsorption is less common, and atypical and silent presentations are increasing. Most individuals are being seen by primary care providers and a broad range of specialists. Therefore, heightened awareness of this disease is imperative. Education of physicians, registered dietitians, and other health providers is needed.

The panel recommends the following:

  • Education of physicians, dietitians, nurses, and the public about celiac disease by a trans-National Institutes of Health (NIH) initiative, to be led by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), in association with the Centers for Disease Control and Prevention.
  • Standardization of serologic tests and pathologic criteria for the diagnosis of celiac disease.
  • Adoption of a standard definition of a gluten-free diet based on objective evidence such as that being developed by the American Dietetic Association.
  • Development of an adequate testing procedure for gluten in foods and definition of standards for gluten-free foods in the United States to lay the foundation for rational food labeling.
  • Formation of a federation of celiac disease societies, celiac disease interest groups, individuals with celiac disease and their families, physicians, dietitians, and other health care providers for the advancement of education, research, and advocacy for individuals with celiac disease.

CLINICAL ALGORITHM(S)

None provided

EVIDENCE SUPPORTING THE RECOMMENDATIONS

TYPE OF EVIDENCE SUPPORTING THE RECOMMENDATIONS

The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature.

IDENTIFYING INFORMATION AND AVAILABILITY

BIBLIOGRAPHIC SOURCE(S)

  • National Institutes of Health (NIH) Consensus Development Panel on Celiac Disease. Celiac disease. Bethesda (MD): U.S. Department of Health and Human Services (DHHS); 2004 Aug 9. 15 p.

ADAPTATION

Not applicable: The guideline was not adapted from another source.

DATE RELEASED

2004 Aug 9

GUIDELINE DEVELOPER(S)

National Institutes of Health (NIH) Consensus Development Panel on Celiac Disease - Independent Expert Panel
Office of Medical Applications of Research (NIH) - Federal Government Agency [U.S.]

GUIDELINE DEVELOPER COMMENT

National Institutes of Health (NIH) consensus and state-of-the-science statements are prepared by independent panels of health professionals and public representatives on the basis of (1) the results of a systematic literature review prepared under contract with the Agency for Healthcare Research and Quality (AHRQ), (2) presentations by investigators working in areas relevant to the conference questions during a 2-day public session, (3) questions and statements from conference attendees during open discussion periods that are part of the public session, and (4) closed deliberations by the panel during the remainder of the second day and morning of the third. This statement is an independent report of the panel and is not a policy statement of the NIH or the Federal Government.

SOURCE(S) OF FUNDING

United States Government

GUIDELINE COMMITTEE

National Institutes of Health (NIH) Consensus Development Panel

COMPOSITION OF GROUP THAT AUTHORED THE GUIDELINE

Panel Members: Charles O. Elson, MD, Panel and Conference Chairperson, Professor of Medicine and Microbiology, Vice Chair for Research, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama; Martha Ballew, MEd, RD, CNSD, LDN, Pediatric Nutrition Support Dietitian, Division of Pediatric Gastroenterology, Hepatology, and Nutrition/Nutrition Services, Vanderbilt University Medical Center, Nashville, Tennessee; John A. Barnard, MD, Professor of Pediatrics, Divisions of Molecular Medicine and Gastroenterology, The Ohio State University College of Medicine and Public Health, Vice President of Scientific Affairs and Director of Center for Cell and Vascular Biology, Columbus Children’s Research Institute, Columbus, Ohio; Steven J. Bernstein, MD, MPH, Associate Professor of Internal Medicine, Associate Research Scientist of Health Management and Policy, University of Michigan, Research Scientist, Center for Practice Management and Outcomes Research, Ann Arbor VA Healthcare System, Ann Arbor, Michigan; Irene J. Check, PhD, D(ABMLI), Professor of Pathology, The Feinberg School of Medicine, Northwestern University, Director, Clinical Pathology Division, Department of Pathology, Evanston Northwestern Healthcare, Evanston, Illinois; Mitchell B. Cohen, MD, Professor of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio; Sara Fazio, MD, Vice Chair, Core I Medicine Clerkship Committee, Harvard Medical School, Division of General Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; John F. Johanson, MD, MSc, Clinical Associate Professor, Department of Medicine, University of Illinois College of Medicine, Rockford, Rockford Gastroenterology Associates, Ltd., Rockford, Illinois; Noralane M. Lindor, MD, Associate Consultant, Department of Medical Genetics, Mayo Clinic, Rochester, Minnesota; Elizabeth Montgomery, MD, Associate Professor of Pathology and Oncology, Director, Clinical Gastrointestinal Pathology, Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland; Lisa H. Richardson, Consumer Representative, National Chairperson of the Board Emeritus, Crohn’s and Colitis Foundation of America, Inc., Houston, Texas; Douglas Rogers, MD, Section Head of Pediatric Endocrinology, The Cleveland Clinic, Cleveland, Ohio; Sandeep Vijan, MD, MS, Assistant Professor of Internal Medicine, University of Michigan Physician-Scientist, Ann Arbor Veterans Affairs Health Services, Research and Development, Ann Arbor, Michigan

FINANCIAL DISCLOSURES/CONFLICTS OF INTEREST

Not stated

GUIDELINE STATUS

This is the current release of the guideline.

GUIDELINE AVAILABILITY

Electronic copies: Available from the National Institutes of Health (NIH) Consensus Development Conference Program Web site.

Print copies: Available from the NIH Consensus Development Program Information Center, PO Box 2577, Kensington, MD 20891; Toll free phone (in U.S.), 1-888-NIH-CONSENSUS (1-888-644-2667); autofax (in U.S.), 1-888-NIH-CONSENSUS (1-888-644-2667); e-mail: consensus_statements@mail.nih.gov.

AVAILABILITY OF COMPANION DOCUMENTS

PATIENT RESOURCES

None available

NGC STATUS

This NGC summary was completed by ECRI on October 7, 2004. The information was verified by the guideline developer on November 16, 2004.

COPYRIGHT STATEMENT

No copyright restrictions apply.

DISCLAIMER

NGC DISCLAIMER

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