Survey of gastroenterologists on the diagnosis and treatment of adult patients with celiac disease in British Columbia

A recent survey of physician specialists from New York City suggested that few patients with celiac disease are seen and that management experience is limited. The present study, using a survey similar to that of the New York City investigation, evaluated the diagnostic and management experience of specialists for adult celiac disease patients in British Columbia. Four hundred and four patients were reported in the combined clinical practice experience of the responding physicians. Of these, 59, or 15%, were diagnosed in the prior year. Although each physician diagnosed an average of 2.4 new celiac disease patients per year in their entire practice experience, an average of over 4.0 new celiac disease patients were detected in the past year. Most patients presented with diarrhea, weight loss, anemia or nutrient deficiency, but about 14% were asymptomatic or diagnosed by an incidental small intestinal biopsy done at upper gastrointestinal endoscopy. Specialist physicians in British Columbia usually refer patients to their family physicians, dietitians and patient support groups for continued care and appear to rarely rely on serological assays, including antibody tests, for detection of celiac disease in adults. An associated or complicating lymphoma was detected in 16 of 404 patients (4%). Recognition of biopsy-defined celiac disease appears to be increasing in British Columbia.