Increased Prevalence of Celiac Disease in Patients With Dyspepsia

Abstract

The present results indicate that the prevalence of CD in patients with dyspepsia is twice that of the general population. Thus, serological screening for CD should be considered in the early workup of these patients to allow diagnosis and treatment of an eminently treatable disease.

Celiac disease prevalence is not increased in patients with functional dyspepsia

“…The question whether dyspeptic patients have an increased risk of CD has been previously assessed, with conflicting results (2,4,7,13) . Some limitations must be mentioned: some of these studies were underpowered or did not use a pre-specified definition of dyspepsia.…”

“…Previous evidence trying to assess the risk of CD among dyspeptic patients has been inconclusive, showing in some cases notorious discrepancies (2,4,7,13) . This may be due to methodological differences in the way they were designed.…”

Specific Coeliac Disease Antibodies and Microenteropathy

“…We know that damages in gluten sensitivity are not confined to the small intestine (17) and no every gluten sensitive patients develop severe mucosal small bowel abnormality. Several studies have demonstrated that continues exposure to gluten may damage the structure and function of the gastric mucosa in gluten-sensitive patients (18,19). Other surveys indicate that approximately 20% of patients with dyspeptic symptoms have erosive esophagitis, 20% are estimated to have endoscopy-negative reflux disease , 1 0% have peptic ulcer, 2% h ave Barrett esophagus (20) and the results of the present study suggest that at least 2-3% coeliac disease with histology confirmation could be added to the list.…”

“…Atypical forms of CD have increased considerably (7) and the presence of dyspepsia as a unique symptom has been frequently attributed to CD (8). In classical CD with prominent malabsorptive features, dyspepsia may be one of the symptoms.…”

“…It has been reported that the frequency of CD in people with dyspeptic complaints is 1.1-3%, which is two to nine times higher than in the general population around the world (6,(8)(9)(10)(11)(12). Anti-endomysial antibodies (EmA) were confirmed to be less sensitive than IgA tTG antibodies, although at present, human recombinant tissue transglutaminase (tTG) antibodies of IgA class are considered the most sensitive marker (8)(9)(10)(11). Moreover, a new serological test that is, antibodies to deamidated gliadin peptides (DGP) -has been proposed as a screening test for CD, since many retrospective and perspective studies showed a very high diagnostic accuracy of this immune marker.…”