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Introduction: Celiac disease (CD) is an autoimmune disease that affects genetically predisposed individuals. In course of the disease, consumption of gluten causes damage to the small intestine. Due to various clinical manifestations, diagnosing CD poses a challenge to clinicians. It has been proven by several study groups that the diagnostic delay in CD is still too long and provokes severe health complications. Purpose: The aim of the study is to highlight the importance of diagnostic delay in CD, its consequences and possible solutions. Description of the state of knowledge: The diagnosis of CD is based on the clinical picture, serological test, duodenal mucosal biopsies and genetic tests. Many cases of CD remain undiagnosed in spite of published guidelines for CD diagnosis. Consequently, the diagnosis is significantly delayed: the mean duration of the diagnostic process in Poland was 7.3 years. In other countries, patients the time from the onset of the symptoms to establishing CD diagnosis was up to 10 years. The diagnostic delay leads to reduced quality of life and the development of severe complications, such as neoplastic disease. Summary: Diagnostic delay in CD is an issue of great importance. Because of the reduced quality of life and the possibility of neoplasm, it is crucial to take action in order to shorten the diagnostic process of CD.

Abstract Background Coeliac disease (CD) is characterised by diverse clinical symptoms, which may cause diagnostic problems and reduce the patients’ quality of life. A study conducted in the United Kingdom (UK) revealed that the mean time between the onset of coeliac symptoms and being diagnosed was above 13 years. This study aimed to analyse the diagnostic process of CD in Poland and evaluate the quality of life of patients before and after CD diagnosis. In addition, results were compared to the results of the original study conducted in the UK. Methods The study included 2500 members of the Polish Coeliac Society. The patients were asked to complete a questionnaire containing questions on socio-demographic factors, clinical aspects and quality of life, using the EQ-5D questionnaire. Questionnaires received from 796 respondents were included in the final analysis. Results The most common symptoms reported by respondents were bloating (75%), abdominal pain (72%), chronic fatigue (63%) and anaemia (58%). Anaemia was the most persistent symptom, with mean duration prior to CD diagnosis of 9.2 years, whereas diarrhoea was observed for the shortest period (4.7 years). The mean duration of any symptom before CD diagnosis was 7.3 years, compared to 13.2 years in the UK. CD diagnosis and the introduction of a gluten-free diet substantially improved the quality of life in each of the five EQ-5D-5L health dimensions: pain and discomfort, anxiety and depression, usual activities, self-care and mobility (p