Your ESPGHAN podcast team are collecting expertise from as many learnèd, skilled, and experienced paediatric gastroenterologists and hepatologists as possible! Oh, and from dietitians… they’re among the most important links in the chain between gastroenterologist and the universal goal – a healthy child and a happy family.

Today’s note accompanies an encounter with Dr Elin Malmberg Hård af Segerstad, whose principal interests lie in the origins and management of the immune dysregulation manifest as coeliac disease.

In a person with an inherited susceptibility to coeliac disease, what triggers the development of that disease? Can triggers be avoided, and if so, how? After diagnosis and treatment, how can a patient with coeliac disease be monitored for compliance with dietary regimens? Who is best positioned to monitor such patients?

Dr Hård af Segerstad poses questions on three points as an armature for discussion:

1. What rôle does diet play in the development of coeliac disease in children? Can dietary modifications prevent coeliac disease?

2. How can gluten-free diet adherence be best assessed in children with coeliac disease? How does clinical practice at present fall short in this regard?

3. What is the rôle of the dietitian in the management of coeliac disease in children? Should all children with coeliac disease have access to an experienced dietitian?

In addressing these questions, she builds on three articles listed below – consensus summaries of best practice. But she also goes into detail on particular aspects of dietetic care not covered in those articles, so listen carefully!

• Mearin ML et al. ESPGHAN position paper on management and follow-up of children and adolescents with celiac disease. J Pediatr Gastroenterol Nutr 2022 Sep 1; 75(3):369–386.Doi: 10.1097/MPG.0000000000003540. Epub 2022 Jun 27. PMID: 35758521

• Luque V et al. Gluten-free diet for pediatric patients with coeliac disease: A position paper from the ESPGHAN gastroenterology committee, special interest group in coeliac disease. J Pediatr Gastroenterol Nutr 2024 Apr; 78(4):973–995.Doi: 10.1002/jpn3.12079. Epub 2024 Jan 30. PMID: 38291739

• Szajewska H et al. Early diet and the risk of coeliac disease: An update 2024 position paper by the ESPGHAN special interest group on coeliac disease. J Pediatr Gastroenterol Nutr 2024 Aug; 79(2):438–445.Doi: 10.1002/jpn3.12280. Epub 2024 Jun 7. PMID: 38847232

  Dr. Malmberg´s favourite song: Måns Zelmerlöw - Heroes

ESPGHAN favourite songs can be found on Spotify: https://open.spotify.com/playlist/0YIHKjxITLEm9XNyHyypTo