Frequency Of Celiac Disease Among Patients With Chronic Gastrointestinal Symptoms

Background: Celiac disease is an immune-mediated enteropathy that may present with chronic gastrointestinal symptoms and remains underdiagnosed because of its diverse clinical manifestations. Objective: To determine the frequency of celiac disease among patients presenting with chronic gastrointestinal symptoms and identify associated clinical predictors. Methods: This cross-sectional analytical study was conducted at Nishtar hospital Multan from march 2025 to march 2026 including 168 patients presenting with chronic gastrointestinal symptoms for more than three months. Results: The mean age of participants was 35.9 ± 12.4 years, with females comprising 56.0% of the study population. Anti-tTG serology was positive in 34 (20.2%) patients, while histologically confirmed celiac disease was identified in 22 (13.1%). Bloating (57.1%), abdominal pain (53.0%), and chronic diarrhea (42.9%) were the most common symptoms. Patients with confirmed celiac disease were younger (29.7 ± 9.3 vs. 36.8 ± 12.6 years; p=0.01) and had lower BMI (20.6 ± 3.7 vs. 24.3 ± 4.5 kg/m²; p<0.001). Positive anti-tTG serology was the strongest predictor of confirmed disease (aOR 6.84; p<0.001), followed by iron deficiency anemia (aOR 4.18), chronic diarrhea (aOR 3.42), BMI <22 kg/m² (aOR 3.06), and unexplained weight loss (aOR 2.89). Conclusion: Celiac disease is a significant underlying cause of chronic gastrointestinal symptoms and should be actively considered in patients with suggestive gastrointestinal and malabsorptive clinical features.

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