Interpretation and implementation of the revised European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines on pediatric celiac disease amongst consultant general pediatricians in Southwest of England

Celiac disease in the East and the West: Bridging the gaps between the guidelines and their implementation in daily practice is mandatory

“…While there are well-defined guidelines for the diagnosis of CeD with both biopsy and non-biopsy approaches, the awareness and uptake of guidelines by pediatricians and physicians is not optimal. The study by Paul et al [1] was primarily aimed at assessing awareness of the non-biopsy pathway of the ESPGHAN 2012 criteria among pediatricians practicing in Southwestern England. While 100 of 101 respondents were aware of the existence of such criteria, only 17 respondents stated that all the criteria were required for the diagnosis by a non-biopsy pathway, and 33 of them would make a diagnosis based on the anti-tTG titer alone even in asymptomatic children [1].…”

“…The study by Paul et al [1] was primarily aimed at assessing awareness of the non-biopsy pathway of the ESPGHAN 2012 criteria among pediatricians practicing in Southwestern England. While 100 of 101 respondents were aware of the existence of such criteria, only 17 respondents stated that all the criteria were required for the diagnosis by a non-biopsy pathway, and 33 of them would make a diagnosis based on the anti-tTG titer alone even in asymptomatic children [1]. The study from India by Malik et al [2] reflects the current practice pattern in India and the data is alarming.…”

“…Recently, two questionnaire-based surveys of pediatricians, one from UK by Paul et al and another by Malik et al from India, have been published in the Indian Journal of Gastroenterology, which highlight the pattern of current practices in the diagnosis and management of patients with celiac disease (CeD) [1,2]. While Paul et al [1] utilized either a telephone or an electronic mail to conduct their survey involving 100 pediatricians practicing in Southwestern England, Malik et al [2] used electronic mail alone involving 271 pediatricians across India. Paul et al focused primarily on the awareness of pediatricians about European Society of Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guideline of the non-biopsy pathway for the diagnosis of CeD [1].…”

“…While Paul et al [1] utilized either a telephone or an electronic mail to conduct their survey involving 100 pediatricians practicing in Southwestern England, Malik et al [2] used electronic mail alone involving 271 pediatricians across India. Paul et al focused primarily on the awareness of pediatricians about European Society of Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guideline of the non-biopsy pathway for the diagnosis of CeD [1]. Malik et al, on the other hand, focused on the overall practice pattern pertaining to CeD such as its most common presenting symptoms, known associations, standard diagnostic criteria, and its management [2].…”

“…Malik et al, on the other hand, focused on the overall practice pattern pertaining to CeD such as its most common presenting symptoms, known associations, standard diagnostic criteria, and its management [2]. These two studies have not only brought a few interesting observations but also a few alarming patterns of practices both for the diagnosis and the management of CeD [1,2]. We have selected a few relevant points from both the studies, and we have reviewed the standard guidelines and the relevant literature around these points and summarized these in this technical report.…”