CD tx requires a strict gluten free diet GFD and lifelong medical f u

By rray, 3 May, 2023
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<sup>1</sup> Gluten contamination of oats, variable toxicity in different varieties of oats, and small risk of immune rxn to oat protein avenin requires monitoring for oat tolerance.
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Setting a goal of intestinal healing is suggested as an endpoint to GFD tx Individualized discussion w the pt on the goals of GFD beyond serological remission is recommended C L o In adult pts after shared decision making consider f u bx for assessment of
Routine use of gluten detection devices in food or biospecimens isn t recommended C L o Interview w dietitian w GFD expertise is standard of care in assessing diet adherence o Gluten detection technologies may not distinguish between clinically significan
There s insufficient evidence to recommend for against probiotics for CD tx EvGap VL o Dysbiosis is a feature of CD but its role in pathogenesis and symptomatology is uncertain o Despite widespread use of probiotics their benefit in CD isn t established
Consumption of gluten free oats is recommended S M 1 o Eating oats seems safe for most CD pts but may be immunogenic in subset o Heterogeneity in oat tolerance may be related to differences in origin harvesting and quantity of oats consumed o Intervals fo
Pneumococcal vaccination suggested C L o Vaccination against pneumococcal infxn is safe and effective in CD pts o Vaccination is recommended for all adults 65 yo and smokers 19 64 yo and in adults w certain underlying conditions
Additional considerations o Referral to a dietitian is mandatory after CD dx w subsequent visits as needed to reinforce GFD education and adherence o Additional tests to consider at time of CD dx CBC ALT AST vitamins A D E B12 Cu Zn folic acid ferritin Fe
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CD tx requires a strict gluten-free diet (GFD) and lifelong medical f/u.