Category: Small Intestine
Background: Adult coeliac disease (ACD) is increasingly recognized in areas where it was previously considered rare. We detail ACD in an Irish provincial centre (IrP), making comparison with reports from three such areas.
Methods: Presentation and demographic features from IrP and published data from an Irish metropolitan centre (IrM), Olmsted County, US (OC), India (Ind) and Brazil (B) are compared.
Results: 97 prospectively enrolled ACD patients (62, 68% Female; B 67%; Ind 56%; OC 66%) mean age at diagnosis 46yrs (B 41; Ind 37; OC 46) were studied. Most common presentations were diarrhoea 42/88, 47% (B 90%; Ind 99%; OC 54%; IrM 75%); weight loss 39/88, 44% (B 70%; Ind 88%; OC 44%; IrM 51%); anaemia 31/88, 35% (B 0%; Ind 66%; OC 35%: IrM 25%); abdominal pain 15/88, 17% (B 56%; Ind 0%; OC 34%; IrM 44%); fatigue 8/88, 9% (OC 21%); steatorrhoea 4/88, 5% (B 0%: Ind 0%; OC 26%; IrM 0%).
Conclusions: Compared with Irish studies, patterns of presentation in the US are similar; in less developed countries, the demographics are comparable but the symptoms are much more blatant. Clearly, reported presenting symptoms are biased by varying triggers for ACD investigation and resources.
