Journal of General Internal Medicine

, Volume 20, Issue 7, pp 644–646

Brief report: Physician awareness of celiac disease

A need for further education


    • Harbor-UCLA Medical Center
  • Mary Farid
    • West Los Angeles Veterans Administration Hospital
  • Donald Baisch
    • The Celiac Disease Foundation
  • Bhairavi Patel
    • The Celiac Disease Foundation
  • Devika Patel
    • The Celiac Disease Foundation
Original Article

DOI: 10.1007/s11606-005-0111-7

Cite this article as:
Zipser, R.D., Farid, M., Baisch, D. et al. J GEN INTERN MED (2005) 20: 644. doi:10.1007/s11606-005-0111-7


BACKGROUND: Celiac disease is a common disorder (up to 0.7%); however, it is uncommonly diagnosed in the United States.

OBJECTIVE: We sought to determine physician awareness of celiac disease.

DESIGN: Surveys completed by 2,440 (47%) of 5,191 patients in a support group were analyzed for frequency of diagnosis by physician specialties. Questionnaires were then sent to primary care physicians (PCPs) (n=132) in a southern California county to assess knowledge of celiac disease.

RESULTS: In patient surveys, only 11% were diagnosed by PCPs (internists and family physicians) versus 65% by gastroenterologists. Physician surveys (70% response) showed that only 35% of PCPs had ever diagnosed celiac disease. Almost all physicians (95%) knew of wheat intolerance, but few (32%) knew that onset of symptoms in adulthood is common. Physicians were well aware (90%) of diarrhea as a symptom, but fewer knew of common symptoms of irritable bowel syndrome (71%), chronic abdominal pain (67%), fatigue (54%), depression and irritability (24%) or of associations with diabetes (13%), anemia (45%) or osteoporosis (45%), or of diagnosis by endomysial antibody tests (44%).

CONCLUSIONS: Lack of physician awareness of adult onset of symptoms, associated disorders, and use of serology testing may contribute to the underdiagnosis of celiac disease.

Key words

celiac diseaseprimary care physiciansendomysial antibodieseducation

Copyright information

© Society of General Internal Medicine 2005