title: Increased risk of surgery in undiagnosed celiac disease.
abstract: The diagnosis of celiac disease patients may be delayed by misdiagnosis. Our aim was to evaluate in celiac patients the prevalence of surgery before diagnosis. Two hundred forty-four adult celiac patients and 232 controls were retrospectively investigated for surgery before diagnosis of celiac disease. The prevalence of surgery was increased in celiac patients versus controls (P = 0.001). Frequency of appendectomy (P = 0.0001), tonsillectomy (P = 0.009), and hernia repair (P = 0.05) were increased in celiac patients versus controls. Appendectomy was related to anemia (P = 0.006) and abdominal pain (P = 0.005); tonsillectomy was related to diarrhea (P = 0.02) and weight loss (P = 0,04). Appendectomy was elective in 73% of celiac patients and in 46% of controls. Cosmetic surgery was increased in celiac patients versus controls (P = 0.058). In conclusions, surgery before celiac disease diagnosis is increased in celiac patients compared to controls, as a result of doctors' misdiagnosis and/or poor health status, which increases the demand for medical intervention. The frequency of cosmetic surgery in celiac patients may berelated to impaired psychological profile of patients.
authors.affiliation: Department of Internal Medicine, Federico II University of Naples, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Ciacci
authors.forename: R
authors.initials: R
authors.lastname: Cavallaro
authors.forename: R
authors.initials: R
authors.lastname: Romano
authors.forename: D S
authors.initials: DS
authors.lastname: Galletta
authors.forename: F
authors.initials: F
authors.lastname: Labanca
authors.forename: M
authors.initials: M
authors.lastname: Marino
authors.forename: M
authors.initials: M
authors.lastname: Donisi
authors.forename: G
authors.initials: G
authors.lastname: Mazzacca
mesh_terms: D000328:Adult; D001062:Appendectomy; D001064:Appendicitis / Q000150:complications / Q000175:diagnosis; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis* / Q000523:psychology; D002763:Cholecystectomy; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative; D014068:Tonsillectomy