Rates of Duodenal Biopsy During Upper Endoscopy Differ Widely Between Providers: Implications for Diagnosis of Celiac Disease

Journal of Clinical Gastroenterology
Max PitmanBenjamin Lebwohl

Abstract

The goal of this study is to determine factors associated with performance of duodenal biopsy during upper endoscopy. Celiac disease (CD) prevalence approaches 1% in the United States and Europe, yet CD remains underdiagnosed, in part because of low rates of duodenal biopsy during upper endoscopy. We aimed to identify patient and provider factors associated with performance of duodenal biopsy during upper endoscopy. In our hospital-based endoscopy suite, we identified all patients not previously diagnosed with CD who underwent upper endoscopy during a 5-year period for one of the following indications: abdominal pain/dyspepsia, gastroesophageal reflux (GERD), anemia/iron deficiency, diarrhea, and weight loss. We employed univariate and multivariate analysis to determine the association between clinical factors and the performance of duodenal biopsy. Of 8572 patients included in the study, 4863 (57%) underwent duodenal biopsy. Of those who underwent duodenal biopsy, 24 (0.49%) were found to have CD. On multivariate analysis, age, gender, indication, gross endoscopic appearance, physician affiliation with a celiac disease center, and absence of a participating trainee were all significantly associated with the performance of duod...Continue Reading

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Citations

Oct 13, 2018·Digestive Diseases and Sciences·Omer Faruk BeserUNKNOWN Northern Cyprus Celiac Study Group
Apr 6, 2019·Journal of Clinical Gastroenterology·Juan LasaIgnacio Zubiaurre
Jan 12, 2021·Gastroenterology Research and Practice·Amir BehforouzLadan Goshayeshi
Feb 19, 2021·Scandinavian Journal of Gastroenterology·Claire L Jansson-Knodell, William R Kessler
Sep 21, 2020·Gastroenterology·Benjamin Lebwohl, Alberto Rubio-Tapia
Aug 24, 2020·Gastroenterology·Don C RockeyDenise Kalmaz

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Methods Mentioned

BETA
biopsy
biopsies

Software Mentioned

SAS

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