The prevalence of celiac disease and the appropriateness of the diagnosis in family medicine setting could be lower than expected

G.M. Giorgetti, I. De Vitis, F. Fabiocchi, A. Chiriatti, G. Nati, R. Cantarini, A. Fiorillo, A. Scarabotti, C. Battimelli, W. Elisei, A. Tursi

Clinical Nutrition Unit, “S. Eugenio” Hospital, Rome, Italy. antotursi@tiscali.it

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• Gastroenterology
• Public Health

OBJECTIVE: To assess the prevalence of celiac disease (CD) and the appropriateness of this diagnosis in the family medicine setting in Italy.

PATIENTS AND METHODS: The electronic databases of 16 general practitioners working in Rome (Italy) were analyzed. The prevalence of CD according to the Italian pathology identification code issued by the Italian National Health System was assessed. In addition, patients registered as having celiac disease without being assigned a pathology identification code were interviewed.

RESULTS: Overall, a population of 22,064 patients was analyzed. 91 patients had a diagnosis of CD (0.41%), 60 of whom had a pathology identification code (0.27%), and 31 did not (0.14%).

29 of these patients were interviewed, 16 (17.58% of the CD recorded patients) of whom reported being on a gluten-free or gluten restricted diet, with reported improvement in their clinical symptoms. Half of them further stated that they would not agree to resume a restriction free diet in order to make a definitive CD diagnosis, due to the risk of symptom recurrence.

CONCLUSIONS: In a family medicine setting, the prevalence of CD seems to be lower than expected, and one third of patients diagnosed with CD do not fulfill all diagnostic criteria. Any effort to improve the diagnostic work-up for CD should also be made in this setting.

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