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394 Celiac Disease Has Higher Treatment Burden Than Common Medical Conditions

Authors :
Mona Akbari
Arjun Bhansali
Sveta Shah
Joshua Hansen
Melinda Dennis
Ciaran P. Kelly
Daniel A. Leffler
Source :
Gastroenterology. 142:S-87
Publication Year :
2012
Publisher :
Elsevier BV, 2012.

Abstract

and 1 patient had 4 previous EGD's. The median time from the first EGD until the diagnostic EGD was 39 months (range: 1 month to 13 years). The same endoscopist performed the non-diagnostic and the diagnostic EGD in 10/17 patients (59%). During the prior nondiagnostic EGD, a duodenal biopsy was performed in only 41% of the patients, and ≥4 specimens (the recommended number) were submitted in 29% of the patients. On the diagnostic EGD, ≥4 specimens were submitted in 94%. CD serologies were obtained in 3/ 17 (18%) prior to the non-diagnostic EGD but were obtained in 10/17 (59%) prior to the diagnostic EGD. During the non-diagnostic EGD's, the indications were dyspepsia/abdominal pain (n=5), reflux or Barrett's esophagus (n=4), diarrhea (n=2), dysphagia (n=2), and other (n=4). During the diagnostic EGD, the indications were diarrhea (n=6), positive CD serologies (n=5), abdominal pain/dyspepsia (n=3), dysphagia (n=2), and reflux (n=1). The mean age of diagnosis of those with missed/incident CD was 53.1 years, slightly older than those diagnosed with CD on their first EGD (46.8 years, p=0.11). Both groups were predominantly female (missed/incident CD: 65% vs. 66%, p=0.94). Conclusions: Among patients with CD who had previously undergone a non-diagnostic EGD, most did not have duodenal biopsies taken on a prior EGD. Dyspepsia and reflux were the predominant symptoms among these patients, and most did not initially have CD serologies checked. Routine performance of duodenal biopsy during EGD for the indications of dyspepsia and reflux may improve the under-diagnosis rates, and shorten the time for diagnosis, of patients with CD in the United States.

Details

ISSN :
00165085
Volume :
142
Database :
OpenAIRE
Journal :
Gastroenterology
Accession number :
edsair.doi...........ad707a648a93c1e77043b4b2e4058758
Full Text :
https://doi.org/10.1016/s0016-5085(12)60330-8