title: Physician awareness of celiac disease: a need for further education.
abstract: BACKGROUND
  Celiac disease is a common disorder (up to 0.7%); however, it is uncommonly diagnosed in the United States.
  
  
  OBJECTIVE
  We sought to determine physician awareness of celiac disease.
  
  
  METHODS
  Surveys completed by 2,440 (47%) of 5,191 patients in a support group were analyzed for frequency of diagnosis by physician specialties. Questionnaires were then sent to primary care physicians (PCPs) (n=132) in a southern California county to assess knowledge of celiac disease.
  
  
  RESULTS
  In patient surveys, only 11% were diagnosed by PCPs (internists and family physicians) versus 65% by gastroenterologists. Physician surveys (70% response) showed that only 35% of PCPs had ever diagnosed celiac disease. Almost all physicians (95%) knew of wheat intolerance, but few (32%) knew that onset of symptoms in adulthood is common. Physicians were well aware (90%) of diarrhea as a symptom, but fewer knew of common symptoms of irritable bowel syndrome (71%), chronic abdominal pain (67%), fatigue (54%), depression and irritability (24%) or of associations with diabetes (13%), anemia (45%) or osteoporosis (45%), or of diagnosis by endomysial antibody tests (44%).
  
  
  CONCLUSIONS
  Lack of physician awareness of adult onset of symptoms, associated disorders, and use of serology testing may contribute to the underdiagnosis of celiac disease.
authors.affiliation: Harbor-UCLA Medical Center, Torrance, USA. rzipser@msn.com
authors.forename: Robert D
authors.initials: RD
authors.lastname: Zipser
authors.forename: Mary
authors.initials: M
authors.lastname: Farid
authors.forename: Donald
authors.initials: D
authors.lastname: Baisch
authors.forename: Bhairavi
authors.initials: B
authors.lastname: Patel
authors.forename: Devika
authors.initials: D
authors.lastname: Patel
mesh_terms: D001364:Awareness; D002140:California; D002446:Celiac Disease / Q000175:diagnosis*; D002983:Clinical Competence; D003625:Data Collection; D003951:Diagnostic Errors; D006801:Humans; D010821:Physicians, Family; D011364:Professional Practice; D012657:Self-Help Groups; D011795:Surveys and Questionnaires