Testing strategies and follow-up for coeliac disease in a general internal medicine outpatient department from 2000 to 2005

Richter, Jens C; Netzer, Peter; Cottagnoud, Philippe; Stucki, Armin (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. Muttenz: EMH Schweizerischer Ärzteverlag

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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..

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology > Centre of Competence for Psychosomatic Medicine
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UniBE Contributor:

Cottagnoud, Philippe and Stucki, Andreas Hans

ISSN:

1424-7860

ISBN:

17183437

Publisher:

EMH Schweizerischer Ärzteverlag

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:47

Last Modified:

06 Dec 2013 13:42

PubMed ID:

17183437

Web of Science ID:

000243057600004

URI:

https://boris.unibe.ch/id/eprint/19739 (FactScience: 2674)

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