Change in frequency of coeliac disease (CD) between 1998 and 2004

Background: Coeliac disease (CD) is a relatively rare disorder. In many cases, the patients have no serious gastrointestinal symptoms and the condition is often diagnosed very late.

Aim: To examine the numbers of new cases, the data on the onset of the symptoms and the new methods of diagnosis in each year from 1998 to 2004.

Patients and methods: The documentation was analysed on all patients who were diagnosed via histopathological samples to have mucosal atrophy. Histological lesions were classified according to the Marsh classification.

Results: The overall number of new cases in the investigated period was 127 (female: 95, male: 32). There was a twofold increase in the incidence of CD in the last 2 years (61/127, i.e. 48% in 2003–2004) relative to the earlier 5 years (66/127 i.e. 52% in 1998–2002). The symptoms generally started 30 months before the setting-up of the diagnosis. In the 85% of the patients the main symptoms were diarrhoea or abdominal discomfort, while 15% of the patients were free of gastrointestinal symptoms. In 66% of the patients the blood iron level was abnormally low. In the first 5 years the diagnosis was confirmed with loading tests (sugar, xylose, lactose and iron), but in the last 2 years antitissue transglutaminase (TTG) antibody, antiendomysium antibody (EMA) and antigliadin antibody (AGA) gave positive results in all 61 patients.

Conclusions: These data appear to reflect a tendency to an increase in the incidence of CD. The long time between the onset of symptoms and the setting-up of the diagnosis demonstrates that the patients with unspecific symptoms reach the gastroenterologist at a late stage. AGA, EMA and TTG can be recommended for the screening of CD.