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| Authors | J Pocock A Caruana Galizia J S Degaetano |
| Abstract | Background: Coeliac disease is thought to be a common and under diagnosed medical condition which is often associated with considerable morbidity and mortality. The presenting symptoms associated with Coeliac disease are often non-specific and clinically silent, as are some of its complications, like oesteoporosis. Coeliac disease is best diagnosed by finding increased epithelial lymphocytes and partial/total villous atrophy on histological examination of biopsies taken from the second part of the duodenum (D2) at gastroscopy. Unfortunately some cases with histologically proven Coeliac disease will have a normal endoscopic mucosal appearance of D2. Aim: To determine if taking a duodenal biopsy on all patients at gastroscopy will diagnose patients with coeliac disease who would otherwise have been missed. Study design: A prospective study in a teaching hospital endoscopy unit during years 2004 and 2005 Method: Altogether 923 consecutive patients attending for gastroscopy were included in this study. At least two distal duodenal biopsies were taken if possible, unless a contraindication was present. Results: In 234 patients a duodenal biopsy was clearly indicated. Duodenal biopsies were also performed on 450 patients from the remaining 689. 5 patients from this group were diagnosed as suffering from coeliac disease, 3 of whom had a normal duodenal appearance at endoscopy. In addition 3 patients were diagnosed with giardiasis while in another patient the biopsy was suggestive of Crohns disease. There were no complications from the procedures. Conclusion: Taking 2 duodenal biopsies on all patients at gastroscopy unless contraindicated will diagnose new cases of coeliac disease. The cost of opportunistic screenig for coeliac is less than Lm2000 per case diagnosed. |
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| Journal | Malta Medical Journal |
| Volume | 15 Issue 1-2/suppl. 2003 |
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| Key words | duodenal biopsy, gastroscopy, opportunistic screening, coeliac disease |