Coeliac disease: one in every 100 people is affected! - Strefa Alergii
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Coeliac disease: one in every 100 people is affected!

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Coeliac disease is a disease that affects one in a hundred people. Since it is so common, it should perhaps seem that we should have no problem diagnosing it. Well, research shows otherwise. And the time from the first symptoms to diagnosis is crucial. In the case of coeliac disease, only an early diagnosis makes it possible to introduce prompt treatment and, as a result, prevent the complications that the consumption of gluten brings to the patient's body [1].

Diagnosis: coeliac disease. How long does a patient have to wait for it in Poland?

Recent reports have shown that in Poland, coeliac disease in children is diagnosed on average three years after the first symptoms appear. Adults, on the other hand, wait as long as 9 years for a diagnosis. It is interesting to note that the time that passes from the appearance of the first symptoms to the diagnosis of the disease varies according to the types of symptoms and the age of the patient. In people whose main symptom was diarrhoea due to coeliac disease, the time to diagnosis was almost five years. In contrast, people whose disease manifested as anaemia waited up to more than nine years for diagnosis [1]! One of the reasons for such a long diagnosis time is that coeliac disease can present very differently in individuals, sometimes even in different ways. This can delay the diagnosis and the implementation of therapy [2, 3].

What is linked to such a late diagnosis of coeliac disease?

The long wait for a diagnosis of coeliac disease and the implementation of therapy has consequences. Chronic diarrhoea can become a cause of weight loss, impaired calcium and vitamin D absorption. This in turn can lead to osteoporosis [4, 5].

Studies have also shown that late diagnosis of coeliac disease and lack of appropriate treatment in the form of the introduction of a strict gluten-free diet is associated with a higher co-occurrence of other autoimmune diseases. These include, among others, autoimmune glomerulonephritis or Sjögren’s Syndrome [6, 7].

Therefore, an early diagnosis of coeliac disease is important, as this can minimise the risk of complications. Introducing a gluten-free diet, especially under the guidance of a specialist dietician, allows the intestinal mucosa to recover quickly. It also makes it possible to supply the body with essential nutrients.

Does a gluten-free diet always bring relief from symptoms?

kobieta odmawiająca jedzenia białego chleba, celiakia

A gluten-free diet is the most effective and only treatment for patients with coeliac disease [8]. However, it turns out that some people continue to experience symptoms despite following the diet. According to a study published last year,  although almost all of the patients surveyed declared that they strictly adhered to the recommended diet, many of them still experienced bothersome symptoms of the condition. In this group of patients, symptoms were still experienced, on average, more than two years after the diagnosis and implementation of therapy. These individuals most frequently complained of bloating or abdominal pain [1].

How does Poland perform in comparison with other countries in the diagnosis of coeliac disease?

The average time from the first symptoms to diagnosis, taking children and adults together in Poland, is almost 7.5 years. However, the situation is no better in other countries. For example, according to some studies, the Swiss wait a similarly long time for a diagnosis of coeliac disease [9]. The British, on the other hand, wait even longer, more than 13 years [10]! It should be noted, however, that in the British study, the majority were adults, which may have caused this longer waiting time for diagnosis than in Poland and Switzerland [11].

Time for conclusions: what can be done to make things better?

The main conclusion from the analysis of the study is the need to find ways to reduce the waiting time for coeliac disease diagnosis in Poland. One solution may be to increase the awareness of doctors about the variety of symptoms and to increase the availability of diagnostic options for coeliac disease. This should result in shorter waiting times for patients to be diagnosed with this disease [1].

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translation: Julia Majsiak

  1. Majsiak, E., et al., Clinical Manifestation and Diagnostic Process of Celiac Disease in Poland—Comparison of Pediatric and Adult Patients in Retrospective Study. Nutrients, 2022. 14(3): p. 491.
  2. Mooney, P.D., et al., Treatment failure in coeliac disease: a practical guide to investigation and treatment of non-responsive and refractory coeliac disease. J Gastrointestin Liver Dis, 2012. 21(2): p. 197-203.
  3. Parzanese, I., et al., Celiac disease: From pathophysiology to treatment. World J Gastrointest Pathophysiol, 2017. 8(2): p. 27-38.
  4. Domsa, E.M., et al., Celiac disease: a multi-faceted medical condition. J Physiol Pharmacol, 2020. 71(1).
  5. Leonard, M.M., et al., Celiac Disease and Nonceliac Gluten Sensitivity: A Review. JAMA, 2017. 318(7): p. 647-656.
  6. Ventura, A., G. Magazzù, and L. Greco, Duration of exposure to gluten and risk for autoimmune disorders in patients with celiac disease. SIGEP Study Group for Autoimmune Disorders in Celiac Disease. Gastroenterology, 1999. 117(2): p. 297-303.
  7. Volta, U., et al., The changing clinical profile of celiac disease: a 15-year experience (1998-2012) in an Italian referral center. BMC Gastroenterol, 2014. 14: p. 194.
  8. Choung, R.S., et al., Effect of a Gluten-free Diet on Quality of Life in Patients With Nonclassical Versus Classical Presentations of Celiac Disease. Journal of Clinical Gastroenterology, 2020. 54(7): p. 620-625.
  9. Vavricka, S.R., et al., Celiac disease diagnosis still significantly delayed – Doctor’s but not patients’ delay responsive for the increased total delay in women. Dig Liver Dis, 2016. 48(10): p. 1148-54.
  10. Majsiak, E., et al., The impact of symptoms on quality of life before and after diagnosis of coeliac disease: the results from a Polish population survey and comparison with the results from the United Kingdom. BMC Gastroenterol, 2021. 21(1): p. 99.
  11. Fuchs, V., et al., Delayed celiac disease diagnosis predisposes to reduced quality of life and incremental use of health care services and medicines: A prospective nationwide study. United European Gastroenterol J, 2018. 6(4): p. 567-575.