August 2009 journal finds disease grossly under diagnosed.
An article published in the August 2009 journal of the American Dietetic Association stresses the need for increased awareness of celiac in the medical community is needed to help gain diagnosis for those currently suffering from the disease. The case study analysis led by Aviva Shemesh, MSc, RD out of The Hebrew University of Jerusalem also suggests that prevalence of celiac disease in Israel, like many other countries, is more common than previously thought.
Current Barriers to Diagnosis
The article entitled,“Importance of Nutritional Assessment and Collaboration between Physicians and Registered Dietitians in Detecting Celiac Disease: Two Case Studies", determined that the multitude and diversity of symptoms and presentations associated with celiac was a major challenge currently facing practitioners, as only a minority of patients presented with the typical symptoms ‘as described in textbooks’.
Conditions such as anemia were identified to be common in patients who exhibited non-classical presentations of celiac, and increased screening for the disease in these patients by primary physicians was recommended.
“The disease might not only be symptom-free, but can also present with diverse symptoms or masquerade as other diseases. A recent review study of CD concluded that many patients with CD seek health care for a great variety of common symptoms and that the more frequent use of screening is uncovering more cases of the disease.”
Rising Incidence of Celiac Disease.
Additionally, the article suggests that current prevalence rates of celiac in Israel (1 in 157) is an underestimation. Authors cite 2002 research of Israeli blood donors demonstrates that previous studies to determine prevalence of celiac do not accurately reflect the presence of the disease in those who exhibit known associated symptoms such as anemia, as well as women, who are more likely to have the disease than men.
“Importance of Nutritional Assessment and Collaboration between Physicians and Registered Dietitians in Detecting Celiac Disease: Two Case Studies”, recommends the increase in awareness and understanding of celiac disease in all health professionals involved in patient primary care including physicians, nurses and dietitians.
Increased Collaboration Among Medical Professionals Can Help Increase Diagnosis.
The authors believe registered dietitian’s patient assessments can be an effective tool in the diagnostic process, and “cooperation between the primary physician and RD can lead to improved accuracy and diagnosing CD and better treatment results.”
"Importance of Nutritional Assessment and Collaboration between Physicians and Registered Dietitians in Detecting Celiac Disease: Two Case Studies." Aviva Shemesh, MSc, RD; Ronit Endevelt, PhD, RD; Shlomo M. Monnickendam, MD. The Journal of the American Dietetic Association, August 2009, Volume 109, Number 8. Pages 1445-1448.