Prevalence of Celiac Disease in Patients with Chronic Diarrhea

Celiac.com 07/08/2024 - Celiac disease is a chronic inflammatory condition that primarily affects the digestive system and is known for causing malabsorption due to damage to the small intestine's lining. This condition is triggered by the consumption of gluten, a protein found in wheat, barley, rye, and some types of oats. Celiac disease can lead to a variety of symptoms and is often underdiagnosed due to its broad range of clinical presentations. This study aims to determine the prevalence of celiac disease in patients presenting with chronic diarrhea at the gastroenterology outpatient department of Jinnah Hospital in Lahore, as chronic diarrhea is a common symptom in adults with celiac disease.

Study Methods

The study was conducted over a six-month period from December 2021 to June 2022 and included 140 patients aged 18 to 50 who had chronic diarrhea. Exclusion criteria included lack of informed consent and a history of abdominal trauma or surgery. The data collected included age, gender, family history of celiac disease, and clinical symptoms. Diagnostic methods used in the study were serum tissue transglutaminase antibody IgA and IgG levels, endoscopy, and duodenal biopsy. The results were analyzed using statistical software with a p-value of ≤0.05 considered significant.

Results

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Of the 140 patients studied, 80 were male with a mean age of 21 years. Common symptoms included weight loss (73.5%), abdominal pain (20.7%), and stunted growth (5.7%). A family history of celiac disease was reported in 14.29% of patients. Endoscopy findings showed that 77.9% of patients had fissuring of the duodenal mucosa, 15.7% had decreased height of duodenal folds, and 6.4% had nodularity. Histopathological examination revealed that 65% of patients had Marsh III b, 21.4% had Marsh III c, and 9.3% had Marsh III a. Celiac disease was diagnosed in 23.57% of patients. Significant associations were found between celiac disease and female gender, family history of the disease, weight loss, stunted growth, and Marsh III c histopathology.

Discussion

Celiac disease affects approximately 0.5% to 1% of the global population but is often underdiagnosed due to its diverse range of symptoms. The condition is more prevalent among individuals with certain genetic syndromes and autoimmune diseases. The prevalence of celiac disease in the Asia-Pacific region varies, with different studies reporting between 0.22% and 1.41% among adults and children. Diagnosing celiac disease can be challenging due to its varied clinical manifestations. While serologic testing is crucial, it can sometimes be overlooked due to the variability in symptoms.

The study found a higher prevalence of celiac disease among females and patients with a positive family history of the disease, consistent with findings from other studies. The limitations of this study include the relatively small sample size and focus on a single hospital, which may not be representative of the broader population. Future research with larger, multicenter cohorts is needed to confirm these findings and provide a more comprehensive understanding of the prevalence and demographic patterns of celiac disease in patients presenting with chronic diarrhea.

Conclusion

This study highlights a significant association between chronic diarrhea and celiac disease, suggesting that celiac disease should be considered in patients with chronic diarrhea. The higher prevalence of celiac disease among females and those with a family history of the condition underscores the importance of demographic and familial factors in the diagnostic process. Comprehensive diagnostic protocols, including serologic testing and, when necessary, endoscopic and histopathological examinations, are essential for accurate and timely diagnosis. Early detection and adherence to a strict gluten-free diet can prevent severe complications associated with untreated celiac disease. This study emphasizes the need for increased clinical awareness and thorough investigation of celiac disease in patients presenting with chronic diarrhea to improve patient outcomes through early diagnosis and appropriate dietary management.

Importance of the Study

For individuals suffering from celiac disease, this study is particularly meaningful as it underscores the necessity of considering celiac disease as a potential underlying cause of chronic diarrhea. By highlighting the significant prevalence of celiac disease among patients with chronic diarrhea, the study advocates for more rigorous diagnostic approaches. This can lead to earlier detection and better management of the disease, ultimately improving the quality of life for those affected. Increased awareness and proper diagnosis can help prevent the long-term complications associated with untreated celiac disease, such as intestinal lymphoma and increased mortality.

Read more at: cureus.com