Guidelines for the management of coeliac disease: recommendations of the Intestinal Diseases Section of the Polish Society of Gastroenterology.

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.