Coeliac disease in primary care

doi:10.1136/bmj.39170.410347.80

BMJ 2007;334:704-705 (7 April), doi:10.1136/bmj.39170.410347.80

Editorials

Coeliac disease in primary care

Is common, underdiagnosed, and can present with non-specificsymptoms

The first 150 words of the full text of this article appear below.

Coeliac disease affects around 1% of the general population,but most cases are unrecognised and diagnosis is often delayedconsiderably.¹ ² This is surprising, given how common the diseaseis and how serious its effects can be.¹ ³ ⁴ Several possiblereasons exist for this delay; the most important is that mostpatients with coeliac disease do not have typical symptoms ofmalabsorption. Even if these symptoms are present their non-specificnature may not trigger diagnostic suspicion of coeliac disease.Other atypical presentations can occur, especially in olderpatients,⁵ and the disease may even be seen in obese people.⁶

In this week's BMJ, Hopper and colleagues report a validatedclinical prediction rule to determine an effective diagnosticmethod of detecting all cases of coeliac disease in people referredfor gastroscopy. People with positive tissue transglutaminaseantibodies and "low risk symptoms," as well as those with thehigh risk symptoms of diarrhoea, weight . . . [Full text of this article]

Roger Jones, Wolfson professor of general practice

Department of General Practice and Primary Care, KCL School of Medicine, London SE11 6SP

roger.jones@kcl.ac.uk

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