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How many hospital visits does it take before celiac sprue is diagnosed?
J Clin Gastroenterol 1996; 23(1):21-3JC

Abstract

We studied the hospital records of patients with celiac sprue in order to determine how frequently hospital specialists failed to make the diagnosis. Over a 7 1/2-year period, 39 patients were diagnosed, 49% within the last 18 months of the study period. Fourteen patients (39%) had been referred to the hospital a total of 30 times with features suggestive of celiac sprue, yet without being successfully diagnosed: the delay between initial referral and diagnosis was > 6 years in nine of these patients. The diagnosis was made by gastroenterologists or other internists in 38 (97%) patients. Gastroenterologists had an 85% (33 of 39) diagnostic success rate, other internists 63% (five of eight), and surgeons 7% (one of 14). None of eight referrals to other specialists led to diagnosis. While a history of diarrhea was morel likely to lead to diagnosis, it was reported by only 59% (23 of 39) of patients at the time of diagnosis and at only 46% (32 of 69) of referrals; furthermore, it did not prompt correct diagnosis in 28% (nine of 32). Anemia was the sole manifestation of celiac sprue at 17 referrals, and correct diagnosis was made in only seven (41%), all by gastroenterologists. The perceived rarity of celiac sprue reflects its underdiagnosis. Diagnosis is still delayed even in patients with classic diarrhea, and there is still a failure to appreciate the possible manifestations of sprue, including anemia without gastrointestinal symptoms. Because patients may be referred to specialists other than gastroenterologists with symptoms arising from celiac sprue, a wider knowledge of its manifestations is called for.

Authors+Show Affiliations

Department of Gastroenterology, Antrim Hospital, Northern Ireland.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8835894

Citation

Dickey, W, and J B. McConnell. "How Many Hospital Visits Does It Take Before Celiac Sprue Is Diagnosed?" Journal of Clinical Gastroenterology, vol. 23, no. 1, 1996, pp. 21-3.
Dickey W, McConnell JB. How many hospital visits does it take before celiac sprue is diagnosed? J Clin Gastroenterol. 1996;23(1):21-3.
Dickey, W., & McConnell, J. B. (1996). How many hospital visits does it take before celiac sprue is diagnosed? Journal of Clinical Gastroenterology, 23(1), pp. 21-3.
Dickey W, McConnell JB. How Many Hospital Visits Does It Take Before Celiac Sprue Is Diagnosed. J Clin Gastroenterol. 1996;23(1):21-3. PubMed PMID: 8835894.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - How many hospital visits does it take before celiac sprue is diagnosed? AU - Dickey,W, AU - McConnell,J B, PY - 1996/7/1/pubmed PY - 1996/7/1/medline PY - 1996/7/1/entrez SP - 21 EP - 3 JF - Journal of clinical gastroenterology JO - J. Clin. Gastroenterol. VL - 23 IS - 1 N2 - We studied the hospital records of patients with celiac sprue in order to determine how frequently hospital specialists failed to make the diagnosis. Over a 7 1/2-year period, 39 patients were diagnosed, 49% within the last 18 months of the study period. Fourteen patients (39%) had been referred to the hospital a total of 30 times with features suggestive of celiac sprue, yet without being successfully diagnosed: the delay between initial referral and diagnosis was > 6 years in nine of these patients. The diagnosis was made by gastroenterologists or other internists in 38 (97%) patients. Gastroenterologists had an 85% (33 of 39) diagnostic success rate, other internists 63% (five of eight), and surgeons 7% (one of 14). None of eight referrals to other specialists led to diagnosis. While a history of diarrhea was morel likely to lead to diagnosis, it was reported by only 59% (23 of 39) of patients at the time of diagnosis and at only 46% (32 of 69) of referrals; furthermore, it did not prompt correct diagnosis in 28% (nine of 32). Anemia was the sole manifestation of celiac sprue at 17 referrals, and correct diagnosis was made in only seven (41%), all by gastroenterologists. The perceived rarity of celiac sprue reflects its underdiagnosis. Diagnosis is still delayed even in patients with classic diarrhea, and there is still a failure to appreciate the possible manifestations of sprue, including anemia without gastrointestinal symptoms. Because patients may be referred to specialists other than gastroenterologists with symptoms arising from celiac sprue, a wider knowledge of its manifestations is called for. SN - 0192-0790 UR - https://www.unboundmedicine.com/medline/citation/8835894/How_many_hospital_visits_does_it_take_before_celiac_sprue_is_diagnosed L2 - http://Insights.ovid.com/pubmed?pmid=8835894 DB - PRIME DP - Unbound Medicine ER -