Open AccessDyspepsia and celiac disease: Prevalence, diagnostic tools and therapy
Author(s) -
Laura Petrarca,
Raffaella Nenna,
Gerarda Mastrogiorgio,
Matteo Florio,
Manuela Brighi,
Stefano Pontone
Publication year - 2014
Publication title -
world journal of methodology
Language(s) - English
Resource type - Journals
ISSN - 2222-0682
DOI - 10.5662/wjm.v4.i3.189
Subject(s) - medicine , gastroenterology , asymptomatic , villous atrophy , abdominal pain , population , enteropathy , disease , coeliac disease , endoscopy , environmental health
The prevalence of dyspepsia is up to 40% in population-based study. Functional dyspepsia is an exclusion diagnosis and it is classified as a chronic abdominal pain-related functional disorder, characterized by the presence of persistent or recurrent pain or discomfort centered in the upper abdomen, neither relief by defecation, nor association with the onset of a change in stool frequency or form. Celiac disease (CD) is a common autoimmune enteropathy, with a prevalence around 1% in the general population. Its diagnosis includes a serological screening and an upper gastrointestinal endoscopy with multiple biopsies. Gluten-free diet is the only effective treatment. CD diagnosis is often delayed in asymptomatic patients or in individuals with less clinical gastrointestinal symptoms. Several studies performed coeliac disease screening in patients with symptoms suggestive of dyspepsia, showing a biopsy-proved prevalence that ranged from 0.5% to 2%. The typical endoscopic markers of villous atrophy are not sufficiently sensitive, so some endoscopic techniques, such as "water immersion" and confocal endomicroscopy were proposed to improve the diagnostic sensitivity and target biopsies. A recent meta-analysis estimated that the prevalence of CD was higher in patients with dyspepsia, but not in a statistically significant way. However this assumption should be confirmed further larger studies.