Abstract
diarrhoea (34%) and constipation (30%) (p=0.66). Heartburn, abdominal pain, dyspepsia and bloating were all common being present respectively in 22 (44%), 14 (28%), 14 (28%), and 13 (26%) patients. Weight loss was the least common symptom (18%). Iron deficiency, osteoporosis, thyroid disease and a family history of CD were also common being present respectively in 15 (30%), 5 (10%), 7 (14%), and 6 (12%) patients. There was a significant difference between the unexpected and expected groups for heartburn (62% vs. 31%, p= 0.02) and dyspepsia (52% vs. 10%, p=0.001) but not bloating (38% vs. 17%, p=0.09). Performing routine duodenal biopsy increased the yield of diagnosing CD by 72%, providing an additional 21 cases to the 29 expected cases. The cost of performing routine duodenal biopsy was $44.35 per patient with a total cost of $1980 for every new diagnosis of coeliac disease. Conclusion: given the high prevalence of CD in the population undergoing upper endoscopy, routine duodenal biopsy is a cost-effective way to diagnose a disease that is often missed due to its non-specific presentation.
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