Physician awareness of celiac disease: a need for further education.
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.
Zipser
Robert D
RD
Harbor-UCLA Medical Center, Torrance, USA. rzipser@msn.com
Farid
Mary
M
Baisch
Donald
D
Patel
Bhairavi
B
Patel
Devika
D
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