Clinical presentation of coeliac disease in adult gastroenterological practice

Clinical features, complications and results of investigations are analysed in 50 patients diagnosed by jejunal biopsy as having coeliac disease at the Adult Gastroenterology Unit, Royal Victoria Hospital, Belfast, between 1969 and 1983. Only one patient was entirely asymptomatic, but 22% had no disturbance of bowel habit, and 50% had not lost weight. There were relatively few physical abnormalities on clinical examination. Screening tests using standard haematological and biochemical methods were positive only in between 8% and 52% of patients. More specific tests for malabsorption were positive in between 54% and 84% of patients. Jejunal biopsy remains the definitive procedure to identify patients with coeliac disease.