Brief report: Physician awareness of celiac disease
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
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.
- Fasano A, Catassi C. Current approaches to diagnosis and treatment of celiac disease: an evolving spectrum. Gastroenterology. 2001;120:636–51. CrossRef
- Farrell RJ, Kelly CP. Current concepts: celiac sprue. N Engl J Med. 2002;346:180–8. CrossRef
- Green PHR, Jabri B. Coeliac disease. Lancet. 2003;362:383–91. CrossRef
- Bode S, Gudmand-Hoyer E. Incidence and prevalence of adult celiac disease within a defined geographic area in Denmark. Scand J Gastroenterol. 1996;31:694–9.
- Murray JA, Van Dyke C, Plevak MF, Dierkinsing RA, Zinsmeister AR, Melton LJ. Trends in the identification and clinical features of celiac disease in a North American community 1950–2001. Clin Gastroenterol Hepatol. 2003;1:19–27. CrossRef
- Green PHR, Stavros SN, Panagi SG, et al. Characteristics of adult celiac disease in the USA: results of a national survey. Am J Gastrol. 2001;96:126–31. CrossRef
- Zipser RD, Patel S, Yahya KZ, Baisch DW, Monarch E. Presentations of adult celiac disease in a nationwide patient support group. Dig Dis Sci. 2003;48:761–4. CrossRef
- Cranney A, Zarkadas M, Graham ID, Switzer C. The Canadian celiac health survey—the Ottawa chapter pilot. BMC Gastroenterol. 2003;3:8. CrossRef
- Fasano A, Berti I, Gerarduzzi T, et al. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Arch Intern Med. 2003;163:286–92. CrossRef
- Talley NJ, Valovinos M, Petterson TM, Carpenter HA, Melton LJ III Epidemiology of celiac sprue: a community based study. Am J Gastroenterol. 1994;89:843–6.
- National Institutes of Health, Consensus Development Conference Statement, Celiac Disease. Available at: http://www.consensus.nih.gov. Accessed June 30, 2004.
- Dickey W, McMillan SA. Changing diagnostic pathways in coeliac disease: most case now identified in primary care. Program of the 11th International Symposium on Coeliac Disease, Belfast, Northern Ireland, 2004:167.
- Cronin CC, Feighery A, Ferriss JB, et al. High prevalence of celiac disease among patients with insulin-dependent (type 1) diabetes mellitus. Am J Gastroenterol. 1997;92:2210–2.
- Iltanen S, Collin P, Korpela M, et al. Celiac disease and markers of celiac disease latency in patients with primary Sjogren’s syndrome. Am J Gastroenterol. 1990;94:1042–6.
- Bonamico M, Mariani P, Danesi HM, et al. Prevalence and clinical picture of celiac disease in Italian Down’s syndrome patients: a multicenter study. J Pediatr Gastroenterol Nutr. 2001;33:139–43. CrossRef
- Counsell CE, Taha A, Ruddell WSJ. Coeliac disease and autoimmune thyroid disease. Gut. 1994;35:844–7. CrossRef
- Collin P, Maki M, Keyrilainen O, Hallstrom O, Reunala T, Pasternack A. Selective IgA deficiency and celiac disease. Scand J Gastroenterol. 1992;27:367–71.
- Corazza GR, Di Sario A, Cecchetti L, et al. Influence of pattern of clinical presentation and of gluten-free diet on bone mass and metabolism in adult coeliac disease. Bone. 1996;18:525–30. CrossRef
- Brief report: Physician awareness of celiac disease
Journal of General Internal Medicine
Volume 20, Issue 7 , pp 644-646
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- celiac disease
- primary care physicians
- endomysial antibodies
- Industry Sectors
- Author Affiliations
- 1. Harbor-UCLA Medical Center, Torrance, Calif, USA
- 3. West Los Angeles Veterans Administration Hospital, Calif, USA
- 4. The Celiac Disease Foundation, Studio City, Calif, USA