NICE has updated its guidance on the recognition, assessment and management of coeliac disease in adults, children and young people, replacing the previous CG86 guideline from September 2015.
Serological testing for coeliac disease should be offered to patients with symptoms such as persistent weight loss, unexplained abdominal or gastrointestinal symptoms, unexplained deficiency folate, vitamin B12 or iron, continual mouth ulcers, prolonged fatigue, faltering growth etc.
Patients that have a positive serological test result should be referred to a gastrointestinal specialist for an endoscopic intestinal biopsy which will confirm whether the patient has coeliac disease.
An annual review should be offered to people that have coeliac disease, which should include: a measurement of weight and height and a review of the patients’ symptoms. Additionally, during the annual review the following considerations should be taken into account: if the patient requires a diet assessment looking at their adherence to a gluten-free diet and if they need a specialist diet or nutrition advice. People with coeliac disease and their family members or carers should be given further sources of information on the disease.
Healthcare professionals with specialist knowledge on the disease should explain why a gluten-free diet is important to those patients who have been diagnosed with coeliac disease. Additionally, the specialist healthcare professional should give information on foods that contain gluten and explain suitable alternatives. The information given should include an explanation on: food labelling, eating when travelling abroad, and gluten-free substitutes.
For the full guidance visit: nice.org.uk/guidance/ng20