Population-based screening for celiac disease reveals that the majority of patients are undiagnosed and improve on a gluten-free diet

• Published in: Scientific Reports
• Main Authors: Jan-Magnus Kvamme, Sveinung Sørbye, Jon Florholmen, Trond S. Halstensen
• Format: Article in Journal/Newspaper
• Language: English
• Published: Nature Portfolio 2022
• Subjects: Medicine; R; Science; Q; Norway; Tromsø
• Online Access: https://doi.org/10.1038/s41598-022-16705-2; https://doaj.org/article/00e74e9d3b7a41ad97b2aa796276d003

Abstract The impact of a gluten-free diet (GFD) on screen-detected celiac disease (CD) is currently ambiguous. We aimed to identify the population-based prevalence of undiagnosed adult CD and examine the impact of a GFD on screen-detected CD. In total, 12,981 adults participated in a population-based health study in Tromsø, Norway. Participants with increased levels of anti-tissue transglutaminase-2 IgA or anti-deamidated gliadin peptide IgG were invited to undergo gastroduodenoscopy with both histological and immunohistochemical examination of small-bowel biopsies. The prevalence of previously diagnosed CD was 0.37%. Additionally, the prevalence of previously undiagnosed CD was 1.10%. Thus, 1.47% of the population had CD, of whom 75% were previously undiagnosed. A GFD resulted in significant improvements in overall gastrointestinal symptoms, diarrhea, and health-related quality of life, with reduced abdominal discomfort (76%) and improved levels of energy (58%). The large majority of patients with adult CD were undiagnosed and benefited from a GFD with reduced gastrointestinal symptoms and improved health-related quality of life. In clinical practice, there should be a low threshold for CD testing even in the absence of abdominal complaints because most adult patients appear to consider their symptoms a part of their normal state and therefore remain untested and undiagnosed. Trial registration: Clinical Trials. Gov Identifier: NCT01695681.