| Doctors frequently fail to diagnose a very | | | | you ask them to test you. Even then your |
| common condition known as Celiac disease or | | | | request may be ignored unless you insist because |
| gluten sensitivity. The average delay in diagnosis is | | | | of your family history, advice of family members |
| 11 years in adults. There are several reasons for | | | | or friends, or you present to them your own |
| this delay. Celiac disease was once considered to | | | | research. Their preconceived biases or |
| be rare and affect only young children. This is | | | | misconceptions about Celiac may be difficult to |
| what most doctors practicing today were taught | | | | break. If you have little to no symptoms you still |
| in medical school and they are unaware of how | | | | may need to be tested because of risk factors |
| the spectrum of Celiac disease has changed. | | | | but your doctor may be unfamiliar with the |
| Screening blood donors only recently confirmed | | | | indications for screening of high risk individuals. |
| Celiac disease occurs in 1 in 133 people in the U.S. | | | | It should be noted that many doctors do not like |
| Most physicians are unaware of this for several | | | | to change a diagnosis they have made and |
| reasons: | | | | therefore may fail to consider an alternate |
| Celiac disease is treated by a gluten-free diet not | | | | diagnosis when new symptoms present. Instead |
| a drug. Drug companies subsidize much of the | | | | they may attempt to fit the new symptoms into |
| continuing medical education received by doctors | | | | an existing condition or diagnosis. Because people |
| and most of the medical research in the United | | | | with untreated Celiac disease frequently have |
| States. Without drug company money and | | | | neuropsychiatric symptoms your doctor may label |
| marketing, Celiac disease does not appear in | | | | you depressed, anxious, stressed, neurotic or just |
| medical journal ads or get mentioned by drug | | | | plain crazy. As a result they may stop listening or |
| reps detailing doctors. It is rarely a topic of major | | | | taking your concerns seriously and you may be |
| conferences or research grant proposals. It is a | | | | tempted to stop mentioning your symptoms or |
| disease that is largely "out of site, out of mind" | | | | concerns. |
| for most doctors. | | | | Lastly, doctors are under tremendous pressure to |
| Doctors who actually remember Celiac disease | | | | keep medical costs down. Diagnostic tests are |
| envision in their mind a very young, pale, | | | | one the biggest expenses in medical care and are |
| emaciated child with skinny limbs and a big | | | | ordered by doctors. Many insurance companies |
| "potbelly" like the picture they were shown years | | | | track individual doctors according to the number |
| ago in medical school. The medical history linked | | | | of tests they order. Therefore, your doctors |
| with this image is a malnourished child that is not | | | | may feel pressured to avoid ordering any |
| growing and has numerous, bulky, and foul | | | | perceived "unnecessary tests". For some doctors |
| smelling diarrheal stools. Surveys of primary care | | | | who still believe Celiac disease is rare, blood tests |
| providers have confirmed that most are unaware | | | | or endoscopies required for diagnosis may not be |
| that Celiac occurs in adults. If they do think it | | | | ordered for these reasons. If ordered, however, |
| could occur in adults they do not believe it can | | | | blood tests may be misinterpreted or falsely |
| occur in someone who is overweight and | | | | negative. Endoscopy may be done but no biopsy |
| constipated or has no intestinal symptoms. | | | | performed or poorly interpreted. You and doctor |
| They lack awareness that symptoms such as | | | | may be under the false assurance that Celiac |
| fatigue, bone and joint pain, headaches, and skin | | | | disease and gluten sensitivity have been excluded. |
| rashes are common in Celiac. Most are also | | | | I recommend you help your doctor if you believe |
| unaware that it is associated with other | | | | you may have Celiac disease or gluten sensitivity |
| autoimmune conditions like thyroid disease, | | | | by |
| diabetes, rheumatoid arthritis and lupus. | | | | 1) Writing down all your symptoms and your |
| Malabsorption complications such as anemia and | | | | understanding of how they may be due to gluten |
| osteoporosis are often not recognized as | | | | sensitivity |
| common presentations of untreated Celiac | | | | 2) Sharing your family history, including your |
| disease. Over 250 symptoms involving nearly | | | | ancestry and any genetic tests done |
| every part of the body have been reported in | | | | 3) Being familiar with the diagnostic tests for |
| Celiac disease. Unless you provide your doctor | | | | Celiac disease and gluten sensitivity and their |
| distinct clues such as a family history of Celiac or | | | | limitations |
| mention the possibility that you think you might | | | | 4) Politely ask your doctor to test you for Celiac |
| be gluten sensitive they do not even consider the | | | | disease pointing out why you believe it may be a |
| possibility of it to be the cause of your being ill. | | | | cause of your symptoms |
| Many doctors are unfamiliar with the specific blood | | | | 5) Being willing to undergo adequate and |
| tests or genetic tests for Celiac disease. Others | | | | appropriate evaluation and |
| are not thinking about the possibility of Celiac while | | | | 6) Being prepared to obtain a second opinion if |
| listening to your symptoms so they never | | | | necessary. Being educated and prepared will help |
| consider ordering the blood tests. Either way you | | | | your doctor help you. |
| never have a chance of being diagnosed unless | | | | |