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?
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
