By Beth Hillson
In a study presented at the 2014 Digestive Disease Week conference in Chicago, researchers reported that less than half of people with chronic gastrointestinal symptoms who should be screened for celiac disease actually are evaluated for the disease. The study was headed by Dr. Heba Iskander and examined electronic medical records of all patients visiting Washington University in St. Louis’s Gastrointestinal Center over the course of three months. There were 616 patients in the study, and over half met the criteria set out by the American Gastroenterological Association (AGA) and the American College of Gastroenterology (ACG) for celiac disease screening. Generally, screening is recommended for patients with chronic GI symptoms, such as abdominal pain following eating or chronic diarrhea with weight loss.
The researchers found, however, that only 43.4% of those with an indication for celiac disease screening were ever tested for the condition. Given this finding and the rate of positive diagnoses in the screened group, researchers were able to project that, at least, two celiac disease patients were missed in the three-month period.
The researchers concluded that a more aggressive approach for identifying screening candidates is needed.
This certainly supports figures I’ve seen that celiac disease is under diagnosed. In fact, the web site for the Celiac Disease Center at the University of Chicago reports that 85% of celiac patients are yet to be diagnosed. That number is similar to the percentage quoted by many of the celiac researchers.
So why is this disease missed so frequently? Are physicians really listening when we report our symptoms? Are we speaking clearly about our symptoms and how much they take away from our day-to-day quality of life? And what are our doctors hearing? Did you know that chronic burping can also be a symptom of anxiety? I wonder if that contributes to the frequent reports I hear about being referred to a psychiatrist.
Care to weigh in? How long did it take you to be diagnosed? How many doctors did you see before you were tested for celiac disease?
Reference: Iskandar, Heba, et al. “Celiac Disease Screening is Suboptimal in a Tertiary Gastroenterology Setting.” Gastroenterology, May, 2014.