Bardella MT, Minoli G, Ravizza D, et al Arch Intern Med. 2000 May 22;160(10):1489-91

( 07/09/2000) Approximately 30% to 40% of patients with celiac disease (which affects at least 1 in 200 individuals) also have symptoms of dyspepsia. There is, however, a lack of data regarding the prevalence of celiac disease in patients with dyspepsia.

Methods: All outpatients who underwent an endoscopy of the upper gastrointestinal tract for dyspepsia were enrolled at our center between January and June 1998. All patients under 12 years old were excluded, as were all patients who had been diagnosed with other gastrointestinal diseases, were suspected to have celiac disease, or had malabsorption, and/or iron-deficiency anemia.

Results: 517 (17%) out of 3,019 patients (age range, 20-46 years) were eligible for the study. Endoscopic findings suggested celiac disease in 5 cases, and was histologically diagnosed in 6 of the patients (5 women and 1 man; mean age, 31.3 years). Of the six, 3 had a normal endoscopic pattern, and 3 had a pattern that was consistent with celiac disease. Follow up antiendomysium antibody positivity supported the diagnosis in the patients with histologically diagnosed celiac disease. The relative risk for celiac disease was 2.32 (95% confidence interval, 1.06-5.07) in comparison with the general population, and it was higher among females (3.22; 95% confidence interval, 1.37-7.56).

Conclusions: The prevalence of celiac disease in patents with dyspepsia is twice that of the general population. As a result, serological screening for celiac disease should be considered in the early workup of these patients to allow diagnosis and treatment of what is a treatable disease.

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