RESUMEN
BACKGROUND: Celiac disease presents with a wide spectrum of symptoms
This study clarifies different aspects of celiac disease along with the most common patterns of celiac presentation in Khuzestan Province, Iran
METHODS: Patients' information was obtained by evaluation of their files from the archives of the Khuzestan Celiac Society and records at gastroenterologists' offices in this province
RESULTS: Overall, there were 103 [40 males, 63 females] patients included in this study. Patients' mean ages were 33 +/-11 years [males] and 31.6 +/- 11.7 years [females]. In terms of geographic distribution, 54.1% resided in the center of the province followed by 26.5% who were residents of the northern area. The rate of employment among men was 70.6% whereas it was 8.3% for women. In terms of education, 21.9% of men and 33.3% of women had academic educations. The rate of matrimony was 80.6% [n=29] for men, 65.4% [n=38] for women and 3.4% [n=2] who were divorced. Mean height was 164 +/- 14 cm in men and 157.5 +/- 10 cm in women. Mean BMI at the time of presentation was 22.7 in men and 22.6 in women. The most common gastrointestinal [GI] complaints in male patients were diarrhea [35%], reflux [20%], bloating [17.5%], abdominal pain [15%], vomiting [15%] and constipation [7.5%]. Female patients experienced diarrhea [49.2%], abdominal pain [31.7%], bloating [31.7%], vomiting [19%], constipation [9.5%] and reflux [7.9%]. The most common concomitant non-GI disorders among male patients were anemia [17.1%], thyroid disease [14.3%], and weight loss (14.3%); women experienced anemia [33.9%], thyroid disease [12.5%], and weight loss [7.1%]. Approximately half of the patients exhibited symptoms for more than five years prior to diagnosis and 90% were diagnosed by gastroenterologists. Of these, 43% had normal endoscopy results. The most common serologic markers were anti-TTG [69.9%], anti-EMA [27.7%]
CONCLUSION: Physicians, prior to attributing patients' symptoms to irritable bowel syndrome [IBS] should be aware that patients who present with long-term nonspecific symptoms might possibly have celiac disease. During endoscopy, the threshold for obtaining biopsies should be low