Quality Care in Celiac Disease

Celiac disease is a chronic immune-mediated enteropathy that has adverse health consequences if untreated. Quality care in celiac disease revolves around ensuring an accurate diagnosis and implementing appropriate management. Correct diagnosis is paramount as there are numerous conditions associated with gluten ingestion, but not all carry the same adverse health risks as celiac disease. Serology testing followed by duodenal biopsy is the recommended diagnostic strategy. Tissue transglutaminase immunoglobulin A (TTG-IgA) is the serology test of choice. Proper biopsy technique during esophagogastroduodenoscopy aids in accurate histopathologic confirmation of celiac disease. Diagnosis is the start, not the finish, of gastroenterologist involvement in the care of a patient with celiac disease. A clinic visit to review the new diagnosis and provide the referral to our dietitian partners is essential. Dietitians are key members of the team to instruct and educate patients on the strict, lifelong gluten-free diet, which is presently the only available management strategy for celiac disease. Benefits of the gluten-free diet include resolution of symptoms, normalization of serology, healing of small intestine villi, improvement of nutritional parameters, and reduced morbidity and mortality. Dietary adherence can also help enhance a patient’s quality of life. Regular physician follow-up is vital to providing high-quality celiac disease care.