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: Kvamme, Jan-Magnus, Sørbye, Sveinung, Florholmen, Jon, Halstensen, Trond S.
• Format: Text
• Language: English
• Published: Nature Publishing Group UK 2022
• Subjects: Article; Norway; Tromsø
• Online Access: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9314380/; http://www.ncbi.nlm.nih.gov/pubmed/35879335; https://doi.org/10.1038/s41598-022-16705-2

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.