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Small bowel
To determine the age and gender of patients with coeliac disease 1958–2008 in a single centre
  1. G K T Holmes *1,
  2. F Moor2
  1. 1Department of Gastroenterology, Derby Hospitals Foundation Trust, Derby, UK
  2. 2Department of Dietetics, Derby Hospitals Foundation Trust, Derby, UK

Abstract

Introduction A dedicated coeliac clinic has been running regularly in Derby since 1978. Accurate records have allowed the number of patients with coeliac disease (CD) and the gender split through the years to be determined in an area in Southern Derbyshire served by the Derby hospitals. It is accepted that more females that males are diagnosed with coeliac disease although at what ages this occurs is less clear. The aim of the study was to determine the number of women and men diagnosed with CD in successive 5 year age bands in a large series of biopsy proven patients.

Methods The diagnosis of CD was based on characteristic appearances of the small intestinal mucosa. Extensive efforts were made to identify all adult patients (≤ 15 years of age) in the area served by the Derby hospitals. Sources of information included the hospital diagnostic index, histopathology records, dermatitis herpetiformis clinic, immunology laboratory, dietetics, and membership records of the Coeliac Society (Coeliac UK). Patients were followed prospectively since 1978. The numbers of diagnoses made in successive quinquennia for men and women were determined. Information was stored on an Access data base.

Results For women a steady increase in the number of diagnoses with increasing age up to the age of 40 was observed with the greatest number in the age band 35–45 years. A plateau effect was seen between 45 and 65 years and then a steady decline. For men a steady increase was found to the age band 35–40 years when a plateau was reached which lasted until the age of 70. Thereafter a steady decline was seen. For the age band 20–25 the female to male ratio was 5.6:1. The ratio declined throughout life being 2.53:1 for ages 35–40 and 1.25:1 for the band 85–90.

Conclusion CD in men below the age of 25 years is uncommon compared with women with a female to male ratio of 5.6:1. The greatest number of diagnoses in women is made during the years 35–45. This may be because women consult their doctors more that men so that CD is more likely to be diagnosed. Also the influences of hormones and pregnancy in provoking CD are other factors to be considered. From the age of 40 in men and 45 in women a plateau effect was observed with a decline in old age. In every age band up to 90 years more females than males were diagnosed but the female to male ratio gradually declined throughout life being 1.25:1 in the age band 85–90. It may well be that CD is being missed, particularly in men under 40, and that the diagnosis should be more actively pursued in this group.

  • Age
  • Coeliac disease
  • Diagnosis
  • Gender

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Footnotes

  • Competing interests None.

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