[Celiac disease in adults]

Studies from western countries have shown that coeliac disease (CD) is common with prevalence figures about 1:300. The clinical spectrum varies greatly, steatorrhoea and weight loss affecting less than half of the patients. CD should be suspected in case of positive gliadin (IgA and IgG) and endomysial (IgA) antibodies. The diagnosis is based upon histological examination of duodenal biopsies taken during upper gastrointestinal endoscopy. Most patients respond quickly and satisfactorily to treatment with a gluten-free diet. This treatment also eliminates the excess risk of small bowel malignancy. Screening among first degree relatives and patients with insulin-dependent diabetes mellitus should be considered.