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Celiac disease remains underdiagnosed owing to its heterogeneous clinical presentation, which includes intestinal and extra-intestinal symptoms in children and adults. People without symptoms who are in high risk groups, such as those with certain autoimmune conditions or first degree relatives with celiac disease, should be considered for screening. Whether the general population should be mass screened for celiac disease remains an area of active debate. Although a strict gluten-free diet is the current treatment for celiac disease, dozens of drug therapies in clinical development may radically shift the current paradigm of patient care. This review will cover the epidemiology, pathophysiology, diagnosis, and management of celiac disease, with a focus on recent advances in celiac related patient care and research.<\/jats:p>","DOI":"10.1136\/bmj-2024-081353","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T10:00:11Z","timestamp":1760522411000},"page":"e081353","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Advances in the pathophysiology, diagnosis, and management of celiac disease"],"prefix":"10.1136","volume":"391","author":[{"given":"John B","family":"Doyle","sequence":"first","affiliation":[{"name":"Celiac Disease Center, Columbia University Medical Center, New York, NY, USA"},{"name":"Department of Medicine, Division of Digestive and Liver Diseases, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, 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