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Gastroenterology Research and Practice
Volume 2010, Article ID 170702, 4 pages
http://dx.doi.org/10.1155/2010/170702
Research Article

The Prevalence of Occult Celiac Disease among Patients with Functional Dyspepsia: A Study from the Western Region of Iran

1Department of Gastroenterology and Hepatology, Imam Reza Hospital, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
2Department of Anesthesiology, Critical Care, and Pain Management, Kermanshah University of Medical Sciences (KUMS), Iran
3Department of Public Health Sciences, Division of Social Medicine, Karolinska Institute, Stockholm, Sweden
4Department of Psychology, College of Medicine, Charles Drew University of Medicine and Science, UCLA, Los Angeles, CA, USA
5Psychiatry and Biobehavioral Sciences, Semel Institute, UCLA, Los Angeles, CA 90095, USA

Received 7 July 2010; Revised 13 August 2010; Accepted 28 August 2010

Academic Editor: Giovanni Barbara

Copyright © 2010 Ali Asghar Keshavarz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. The prevalence of Celiac Disease (CD) is high in Iran, and evaluation of CD is not part of the routine screening procedure for dyspeptic patients; therefore, cases of occult CD may be missed. This study aimed to investigate the prevalence of occult CD among dyspeptic patients who presented at a gastroenterology clinic in the Western region of Iran. Methods. In this descriptive, cross-sectional prospective study, patients who had a history of at least 12 weeks of upper abdominal discomfort were eligible to participate in the study during a 14-month recruitment period. Patients with a clinical or paraclinical data in favor of organic causes were excluded from the study. Enrolled patients were screened for IgA antiendomysium antibody (EMA) and IgA antitissue transglutaminase antibody (tTG). Those who screened positive for EMA/tTG received a confirmatory diagnostic biopsy for Marsh classification of CD. Results. From 225 potential participants with dyspepsia, 55 patients were excluded due to having explainable organic causes. The study sample included 170 patients with “functional dyspepsia.” Mean age of participants was 31 years and 55.8% were female. Twelve patients (7%) had positive tests (EMA/tTG), of which 10 were female (83.4%). According to Rome II criteria, all twelve patients with positive tests had “dysmotility type dyspepsia.” Based on Marsh classification, six patients were consistent with “Marsh I,” four with “Marsh II,” and two with the “Marsh III” classification. Conclusions. In this study, the prevalence of CD in dyspeptic patients was high. As a result, this study suggests that screening by serology tests (EMA/tTG) is justifiable for the detection of CD among functional dyspeptic patients in the tertiary centers in our country.