Abstract
Guidelines for the management of coeliac disease: recommendations of the Intestinal Diseases Section of the Polish Society of Gastroenterology
Department of Gastroenterology and Hepatology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland
Department of Gastroenterology and Hepatology, Collegium Medicum, Jagiellonian University, Krakow, Poland
Department of Gastroenterology and Internal Medicine, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
Department of Gastroenterology, Pomeranian Medical University, Szczecin, Poland
Department of Pathomorphology, Department of Gastroenterology, Hepatology and Clinical Oncology, Center of Postgraduate Medical Education, Warsaw, Poland
Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, University Clinical Hospital, Poznan, Poland
Department of Gastroenterology, General Surgery and Nutrition, Copernicus Hospital, Gdansk, Poland
Department of Gastroenterology with IBD Unit, St. Jadwiga the Queen Regional Hospital, Rzeszow, Poland
Faculty of Medicine, Collegium Medicum, University of Rzeszow, Poland
Department of Gastroenterology and Nutrition Disorders, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Poland
Department of Oncological Gastroenterology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
Department of Gastroenterology, Hepatology and Clinical Oncology, Center of Postgraduate Medical Education, Warsaw, Poland
Department of Paediatric Endoscopy and Gastrointestinal Function Testing, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
Department of Digestive Tract Diseases, Medical University of Lodz, Poland
Gastroenterology Rev 2026; 21 (3): 241–277
These guidelines, developed by the Intestinal Diseases Section of the Polish Society of Gastroenterology, aim to improve and standardise the quality of care for patients with coeliac disease. The recommendations are based on the latest scientific evidence and current guidelines published by other recognised international expert societies.
The recommendations were created using a methodology adapted from the GRADE system. The final consensus statements were evaluated by a panel of Polish experts using a Likert scale, with a high degree of consensus (greater than 75%) established as the threshold for acceptance. The document was also reviewed in consultation with representatives of coeliac disease patient advocacy groups.
For diagnostic algorithms, testing for anti-tissue transglutaminase IgA antibodies combined with the level of total serum IgA is recommended as the first-line screening tool. Gastroduodenoscopy with duodenal biopsy is advised as the subsequent diagnostic step; however, specific criteria for a non-biopsy approach in selected groups of both paediatric and adult patients were also defined. Strict adherence to a gluten-free diet remains the cornerstone of treatment. Furthermore, the guidelines establish principles for disease monitoring, provide detailed differential diagnosis for other gluten-related disorders, and outline management algorithms for non-responsive and refractory coeliac disease.
The recommendations of the Polish Society of Gastroenterology provide structured, practical tools for the diagnosis, differentiation, treatment, and monitoring of coeliac disease, thereby optimising clinical decision-making and emphasising an interdisciplinary model of medical care.
Keywords
coeliac disease, enteropathy, gluten, gluten-free diet, gluten-related disorders, villous atrophy
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