For patients with celiac disease, the medical team’s role doesn’t end at diagnosis. Celiacs need active follow-up, including annual medical visits, dietary review and possible routine testing, researchers noted. But a survey of Canadian gastroenterologists found follow-up practices can vary.

According to the survey, while 76% of respondents performed some level of follow-up care, 15% of adult gastroenterologists were not familiar with any celiac disease practice guideline.

More importantly, “the majority of gastroenterologists who did not routinely provide follow-up expected care to be provided by the patient's primary physician (86%),” researchers noted. The finding stresses the importance of education among the primary care community, a subject matter that American gastroenterologists also emphasize.

In light of the survey, researchers concluded: “The diverse practices reported underscore the need to develop consensus-based guidelines for long-term care of these patients."

Based upon the 2004 NIH Consensus Development Conference on Celiac Disease, the following six elements are key in the management of celiac disease :

• Consultation with a skilled dietitian
• Education about the disease
• Lifelong adherence to a gluten-free diet
• Identification and treatment of nutritional deficiencies
• Access to an advocacy group
• Continuous long-term follow-up by a multidisciplinary team