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Increased prevalence of celiac disease in patients with dyspepsia
M T Bardella1, G Minoli, D Ravizza
1Cattedra di Gastroenterologia, Istituto di Scienze Mediche, IRCCS Ospedale Maggiore, Milano, Italy.
Insights
Celiac disease (CD) is twice as common in patients with dyspepsia compared to the general population. Early serological screening for CD is recommended in dyspepsia patients for timely diagnosis and treatment.
Area of Science:
- Gastroenterology
- Internal Medicine
- Clinical Research
Background:
- Celiac disease (CD) affects 1 in 200 individuals.
- 30-40% of celiac disease patients experience dyspeptic symptoms.
- Limited data exists on celiac disease prevalence in dyspepsia patients.
Purpose of the Study:
- To determine the prevalence of celiac disease in patients presenting with dyspepsia.
- To compare the risk of celiac disease in dyspepsia patients versus the general population.
Main Methods:
- Prospective study of outpatients undergoing upper gastrointestinal endoscopy for dyspepsia.
- 3019 patients evaluated; 517 eligible based on exclusion criteria.
- Histological diagnosis of celiac disease confirmed by antiendomysium antibody testing.
Main Results:
- Celiac disease was diagnosed in 6 out of 517 eligible patients (1.15%).
- The relative risk for CD in dyspepsia patients was 2.32 compared to the general population.
- The relative risk was higher in females (3.22).
Conclusions:
- The prevalence of celiac disease is approximately double in dyspepsia patients compared to the general population.
- Serological screening for celiac disease should be considered in the initial evaluation of dyspepsia.
- Early diagnosis and treatment of celiac disease are crucial as it is a highly treatable condition.
Background:
Although 30% to 40% of patients with celiac disease (CD) (which affects 1 in 200 individuals) have dyspeptic symptoms, there is a lack o data concerning the prevalence of CD in patients with dyspepsia.
Methods:
In this prospective series, we enrolled all consecutive outpatients undergoing endoscopy of the upper gastrointestinal tract for dyspepsia at our centers between January and June 1998. The exclusion criteria were age younger than 12 years, workup or follow-up of an already known disease of the gastrointestinal tract, suspected CD, malabsorption, and/or iron-deficiency anemia.
Results:
Of the 3019 patients who were evaluated, 517 (17%) were eligible for the study. Endoscopic findings suggested CD in 5 cases. Celiac disease was histologically diagnosed in 6 patients (5 women and 1 man; mean age, 31.3 years; age range, 20-46 years), 3 of whom had a normal endoscopic pattern and 3 of whom had an endoscopic pattern that was consistent with CD. In the patients with histologically diagnosed CD, antiendomysium antibody positivity supported the diagnosis. The relative risk for CD was 2.32 (95% confidence interval, 1.06-5.07) in comparison with the general population and higher among females (3.22; 95% confidence interval, 1.37-7.56).
Conclusions:
The present results indicate that the prevalence of CD in patients with dyspepsia is twice that of the general population. Thus, serological screening for CD should be considered in the early workup of these patients to allow diagnosis and treatment of an eminently treatable disease.