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Testing strategies and follow-up for coeliac disease in a general internal medicine outpatient department from 2000 to 2005.
Swiss Med Wkly 2006; 136(45-46):732-8SM

Abstract

PRINCIPLES

Coeliac disease (gluten sensitive enteropathy) is a genetically determined disorder with an incidence in the general population that is comparable to type 2 diabetes mellitus. Awareness of this fact and of the often atypical and oligosymptomatic manifestations is only now gaining ground in the medical profession. A high index of suspicion is important in order to minimise diagnostic and therapeutic delay.

METHODS

Testing patterns and follow-up for coeliac disease in our institution have been analysed retrospectively for the past five years. The current literature was reviewed with respect to recommendations for clinical practice.

RESULTS

A total of 271 patients were tested for coeliac disease over a period of five years. Only in 24 patients were positive results found; after further work-up, the final number of cases with certain or presumed coeliac disease was four. Followup was often difficult, many patients being lost after a single visit.

CONCLUSIONS

This study showed that the number of tests ordered in our institution, more often for abdominal than atypical symptoms, has started to increase in the past two years. It also showed that screening tests have found their place in general clinical practice, while the final choice of tests needs to be determined in accordance with available guidelines and local resources. Upper endoscopy with small bowel biopsy remains the gold standard for diagnosis, but its place in follow-up is less certain. Coeliac disease is a disorder for which there is a definite treatment (gluten free diet); if it is left untreated diminished quality of life and potentially serious complications may ensue. Further education of the medical profession regarding coeliac disease, its incidence, presentation and treatment, is clearly indicated..

Authors+Show Affiliations

Klinik und Poliklinik für Allgemeine Innere Medizin, Inselspital, Bern, Switzerland. jenscrichter@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17183437

Citation

Richter, Jens C., et al. "Testing Strategies and Follow-up for Coeliac Disease in a General Internal Medicine Outpatient Department From 2000 to 2005." Swiss Medical Weekly, vol. 136, no. 45-46, 2006, pp. 732-8.
Richter JC, Netzer P, Cottagnoud P, et al. Testing strategies and follow-up for coeliac disease in a general internal medicine outpatient department from 2000 to 2005. Swiss Med Wkly. 2006;136(45-46):732-8.
Richter, J. C., Netzer, P., Cottagnoud, P., & Stucki, A. (2006). Testing strategies and follow-up for coeliac disease in a general internal medicine outpatient department from 2000 to 2005. Swiss Medical Weekly, 136(45-46), pp. 732-8.
Richter JC, et al. Testing Strategies and Follow-up for Coeliac Disease in a General Internal Medicine Outpatient Department From 2000 to 2005. Swiss Med Wkly. 2006 Nov 11;136(45-46):732-8. PubMed PMID: 17183437.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Testing strategies and follow-up for coeliac disease in a general internal medicine outpatient department from 2000 to 2005. AU - Richter,Jens C, AU - Netzer,Peter, AU - Cottagnoud,Philippe, AU - Stucki,Armin, PY - 2006/12/22/pubmed PY - 2007/3/17/medline PY - 2006/12/22/entrez SP - 732 EP - 8 JF - Swiss medical weekly JO - Swiss Med Wkly VL - 136 IS - 45-46 N2 - PRINCIPLES: Coeliac disease (gluten sensitive enteropathy) is a genetically determined disorder with an incidence in the general population that is comparable to type 2 diabetes mellitus. Awareness of this fact and of the often atypical and oligosymptomatic manifestations is only now gaining ground in the medical profession. A high index of suspicion is important in order to minimise diagnostic and therapeutic delay. METHODS: Testing patterns and follow-up for coeliac disease in our institution have been analysed retrospectively for the past five years. The current literature was reviewed with respect to recommendations for clinical practice. RESULTS: A total of 271 patients were tested for coeliac disease over a period of five years. Only in 24 patients were positive results found; after further work-up, the final number of cases with certain or presumed coeliac disease was four. Followup was often difficult, many patients being lost after a single visit. CONCLUSIONS: This study showed that the number of tests ordered in our institution, more often for abdominal than atypical symptoms, has started to increase in the past two years. It also showed that screening tests have found their place in general clinical practice, while the final choice of tests needs to be determined in accordance with available guidelines and local resources. Upper endoscopy with small bowel biopsy remains the gold standard for diagnosis, but its place in follow-up is less certain. Coeliac disease is a disorder for which there is a definite treatment (gluten free diet); if it is left untreated diminished quality of life and potentially serious complications may ensue. Further education of the medical profession regarding coeliac disease, its incidence, presentation and treatment, is clearly indicated.. SN - 1424-7860 UR - https://www.unboundmedicine.com/medline/citation/17183437/full_citation L2 - https://medlineplus.gov/celiacdisease.html DB - PRIME DP - Unbound Medicine ER -