Related Experiment Videos
Case-finding in coeliac disease should be intensified
Chris J J Mulder1, Joep F W M Bartelsman
1Department of Gastroenterology, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. cjmulder@vumc.nl
Best Practice & Research. Clinical Gastroenterology
|June 1, 2005
Summary
Screening for coeliac disease (CD) affects about 1:100 individuals, but costs and benefits for asymptomatic cases remain unclear. A gluten-free diet may impact quality of life, and diagnosis delays can lead to serious health issues.
Area of Science:
- Gastroenterology
- Public Health
- Immunology
Background:
- Coeliac disease (CD) affects approximately 1:100 individuals globally.
- Classic severe malabsorption symptoms are now rare, leading to underdiagnosis.
- Delayed diagnosis of CD can result in long-term complications like autoimmune diseases, osteoporosis, and malignancies.
Purpose of the Study:
- To evaluate the implications of large-scale screening for coeliac disease.
- To discuss the costs and benefits of screening asymptomatic individuals.
- To highlight diagnostic challenges and consequences of delayed CD diagnosis.
Main Methods:
- Review of existing large-scale screening studies on CD prevalence.
- Analysis of potential harms of screening asymptomatic individuals.
- Discussion of diagnostic delays and associated health risks.
Main Results:
- CD prevalence is estimated at 1:100 in the USA, Europe, Middle East, and Australia.
- Screening asymptomatic individuals may pose risks, including reduced quality of life due to strict dietary adherence.
- Delayed diagnosis is common, often overlooked in patients with dyspepsia, IBS, or other autoimmune conditions.
Conclusions:
- Coeliac disease is a significant health concern requiring better diagnostic awareness.
- Nationwide screening programs for CD are not yet established, unlike for other metabolic disorders.
- The adherence and long-term benefits of a gluten-free diet for screen-detected coeliac disease cases remain controversial.