The authors have no conflicts of interest to report. This paper was presented in part at the 68th Annual Meeting of the American College of Gastroenterology, October 10–15, 2004, Baltimore, Md.
Physician Awareness of Celiac Disease
A Need for Further Education
Article first published online: 13 JUN 2005
Journal of General Internal Medicine
Volume 20, Issue 7, pages 644–646, July 2005
How to Cite
Zipser, R. D., Farid, M., Baisch, D., Patel, B. and Patel, D. (2005), Physician Awareness of Celiac Disease. Journal of General Internal Medicine, 20: 644–646. doi: 10.1111/j.1525-1497.2005.0107.x
- Issue published online: 13 JUN 2005
- Article first published online: 13 JUN 2005
- Received for publication January 4, 2005 Accepted for publication January 4, 2005
- celiac disease;
- primary care physicians;
- endomysial antibodies;
Background: Celiac disease is a common disorder (up to 0.7%); however, it is uncommonly diagnosed in the United States.
Objective: We sought to determine physician awareness of celiac disease.
Design: Surveys completed by 2,440 (47%) of 5,191 patients in a support group were analyzed for frequency of diagnosis by physician specialties. Questionnaires were then sent to primary care physicians (PCPs) (n=132) in a southern California county to assess knowledge of celiac disease.
Results: In patient surveys, only 11% were diagnosed by PCPs (internists and family physicians) versus 65% by gastroenterologists. Physician surveys (70% response) showed that only 35% of PCPs had ever diagnosed celiac disease. Almost all physicians (95%) knew of wheat intolerance, but few (32%) knew that onset of symptoms in adulthood is common. Physicians were well aware (90%) of diarrhea as a symptom, but fewer knew of common symptoms of irritable bowel syndrome (71%), chronic abdominal pain (67%), fatigue (54%), depression and irritability (24%) or of associations with diabetes (13%), anemia (45%) or osteoporosis (45%), or of diagnosis by endomysial antibody tests (44%).
Conclusions: Lack of physician awareness of adult onset of symptoms, associated disorders, and use of serology testing may contribute to the underdiagnosis of celiac disease.