Opportunities for Improving Biopsy and Non–Biopsy-Based Diagnosis of Celiac Disease

Robert, Marie E.; Ciacci, Carolina; Lebwohl, Benjamin

doi:10.1053/j.gastro.2024.01.031

Cited by 3 publications

(1 citation statement)

References 91 publications

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“…This no-biopsy approach has been used in the paediatric population for over a decade ( 56 ). Yet, following the same approach to diagnose adults with CD has been a matter of an ongoing debate ( 57 , 58 ). Avoiding unnecessary endoscopy could lead to significant reductions in both the healthcare costs and the carbon footprint of endoscopy ( 59 ).…”

Section: Discussionmentioning

confidence: 99%

Role of endoscopy in the diagnosis of coeliac disease: a narrative review

Shiha,

Yusuf,

Sanders

2024

Transl Gastroenterol Hepatol

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Background and Objective Coeliac disease (CD) is a common autoimmune disorder triggered by gluten consumption in genetically predisposed individuals. CD is characterised by chronic inflammation in the small bowel mucosa with an influx of lymphocytes, followed by crypt hyperplasia and villous atrophy. The gold standard test to diagnose CD is endoscopy with duodenal biopsies. However, variations in practice between endoscopists can lead to missed diagnoses. This review aims to discuss the role of endoscopy in the diagnosis of CD, highlighting the performance measures of endoscopy in CD and the advancement in endoscopic techniques for the optical diagnosis of villous atrophy. Methods We searched PubMed and Google Scholar from their inception to December 2023 for relevant articles on the role of endoscopy in CD. Two authors reviewed these references, and relevant studies were included in the discussion section of this review. Key Content and Findings We provide an up-to-date assessment of the diagnostic accuracy of endoscopic markers of CD and the performance of enhanced endoscopic imaging to identify villous atrophy during endoscopy. We propose a set of benchmarks for endoscopy in CD and discuss the potential role of artificial intelligence (AI) in the endoscopic diagnosis of CD. Conclusions Performing high-quality endoscopy and identifying strategies to reduce inter-endoscopist variations may reduce missed diagnoses. Adopting advanced endoscopic techniques and embracing new technologies such as AI could enhance diagnostic accuracy and improve patient care.

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