Questionnaire showed that Swedish paediatric clinics complied well with the revised European guidelines for diagnosing coeliac disease

Abstract

Aim In 2012, revised criteria for diagnosing childhood coeliac disease were published by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition and incorporated into the revised Swedish guidelines the same year. These made it possible, in certain cases, to diagnose coeliac disease without taking small bowel biopsies. This survey assessed the extent to which the new guidelines were implemented by Swedish paediatric clinics two years after their introduction. Methods In October 2014, we distributed a paper questionnaire including five questions on diagnostic routines to the 40 paediatric clinics in university or regional hospitals in Sweden that perform small bowel biopsies. Results All 36 (90%) clinics that responded used anti‐tissue transglutaminase antibodies as the initial diagnostic test and some also used serological markers. Most clinics (81%) used endoscopy and took multiple duodenal biopsies, whereas only a few (19%) occasionally employed a suction capsule. Almost all clinics (86%) omitted taking small bowel biopsies in symptomatic children with repeatedly high coeliac serology and positive genotyping, thereby avoiding the need for invasive endoscopy under anaesthesia. Conclusion The 2012 Swedish Paediatric Coeliac Disease Diagnostic Guidelines had been widely accepted and implemented in routine health care two years after their introduction.

Two waves of coeliac disease incidence in Sweden: a nationwide population-based cohort study from 1990 to 2015

“…This conclusion is corroborated by a 2019 questionnaire study that found that 86% of the participating clinics avoided endoscopy in children presenting with symptoms typical for CD and highly positive serology. 47 We therefore urge caution when interpreting the incidence data of children beyond 2012. Also, this may, in part, explain the decreasing overall incidence of CD observed 2013-2015.…”