Irritable bowel syndrome is the most commonly diagnosed gastrointestinal condition and affects a large proportion of the population in the West.¹ Several guidelines suggest that in typical patients with no alarm symptoms or signs, apart from routine laboratory tests, no additional tests are necessary.² Coeliac disease, however, may present with symptoms suggestive of irritable bowel disease.³ Several studies suggested that screening for coeliac disease in patients with symptoms suggestive of irritable bowel disease might be cost-effective.^4–7 We, therefore, started to routinely screen patients with typical irritable bowel disease symptoms for coeliac disease using antiendomysial antibodies.

All patients referred to three doctors at the outpatient gastroenterology department of our hospital between November 2002 and …