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394 Celiac Disease Has Higher Treatment Burden Than Common Medical Conditions
- 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