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Gastrointestinal (GI) Diseases

Many conditions fall under the umbrella term GI diseases, including Celiac Disease (CD), Inflammatory Bowel Diseases (IBD) like Crohn’s Disease (CrD) and Ulcerative Colitis (UC), and Irritable Bowel Syndrome (IBS). If undiagnosed, misdiagnosed, or inappropriately treated, these GI diseases can lead to potentially more severe complications, such as an increased risk for colorectal cancer, hemorrhage, bowel blockages or perforations, and intraabdominal abscesses.1

Abdominal pain, chronic diarrhea, iron-deficiency anemia, and other malabsorption symptoms,2,3 are just a few of many similar symptoms that can make differentiating between GI conditions difficult and frustrating.

Symptoms of GI diseases could also indicate the presence of other diseases, as is the case with CD. These patients often have symptoms of iron deficiency anemia, thyroid disease, and infertility.4,5 This is one reason that CD, despite being one of the most common lifelong autoimmune disorders in the world, has surprisingly low correct diagnostic rates:6 2.5M Americans are undiagnosed and are at risk for long-term health complications.3

Prevalence of gastrointestinal diseases worldwide1,2

IBD affects approximately 0.2% of the population in developed countries.7 Celiac disease potentially affects even more, with an estimated global prevalence of between 0.5–1% of the population.4

Multiple Tests are Available to Aid in the Diagnosis

Serological testing can help differentiate GI diseases and provide an accurate, expedited diagnosis. It may help to consider testing when there is presentation of gastrointestinal symptoms or a new diagnosis for a condition that increases the risk for having celiac disease.8 Expediting the time to diagnosis can help alleviate symptoms and improve quality of life.8

Because the symptoms of GI diseases can be similar and overlapping, diagnosing and treating clinicians cannot rely solely on the information gathered during a physical exam and patient history. Laboratory tests can be used to help support the ruling-in or ruling-out of possible GI conditions, confirm the presence of inflammation, and help differentiate diseases. Some tests and procedures a clinician may use include:1, 4-7

Some tests and procedures a clinician may use include:1-5

  • Serological investigations
  • Stool
  • External imaging procedures
  • Endoscopic procedures
  • Biopsies


Since CD diagnosis can require more than 10 years of medical interventions, its early detection can lead to a considerable saving of both economic and medical resources.6 One study, for example, notes that patients with celiac disease in the US incurred costs of $8748 in the 3 years leading up to a diagnosis, whereas the diagnosis itself only incurred an expense of $2707.6 And the true cost of undiagnosed and untreated IBD is notable when you consider that this disease can have serious complications, including a high risk of complications requiring surgery and an increased risk of colorectal cancer.9

  1. World Gastroenterology Organisation. Inflammatory bowel disease guidelines. 2015. http://www.worldgastroenterology.org/UserFiles/file/guidelines/inflammatory-bowel-disease-english-2015-update.pdf. Accessed December 2017. 
  2. Pascual V, Dieli-Crimi R, López-Palacios N, et al. Inflammatory bowel disease and celiac disease: Overlaps and differences. World J Gastroenterol. 2014;20(17):4846-4856.  
  3. Celiac Disease Foundation. What is Celiac Disease? https://celiac.org/celiac-disease/understanding-celiac-disease-2/what-is-celiac-disease/. Accessed October 2017. 
  4. Gujral N, Freeman HJ, Thomson A. Celiac disease: Prevalence, diagnosis, pathogenesis and treatment. World J Gastroenterol. 2012;18(42):6036-6059. 
  5. National Institute for Health and Care Excellence. Coeliac Disease – Recognition, assessment and management (NG20). 2015. https://www.nice.org.uk/guidance/ng20/resources/coeliac-disease-recognition-assessment-and-management-pdf-1837325178565. Accessed November 2017. 
  6. Picarelli A, Di Tola M, Borghini R, et al. The high medical cost of celiac disease missed diagnosis: is it cheaper to suspect it in time? Intern Med. 2014;4:155 
  7. Burri E, Beglinger C. Faecal calprotectin -- a useful tool in the management of inflammatory bowel disease. Swiss Med Wkly. 2012;142:w13557. 
  8. Samasca G, Sur G, Lupan I. Gluten-free diet and the quality of life in celiac disease. Gastroenterol Hepatol Bed Bench. 2014;7(3):139-143. 
  9. Waugh N, Cummins E, Royle P, et al. Faecal calprotectin testing for differentiating amongst inflammatory and non-inflammatory bowel diseases: systematic review and economic evaluation. Health Technology Assessment. 2013;17.55.