Increased risk of surgery in undiagnosed celiac disease

The diagnosis of celiac disease patients may be delayed by misdiagnosis. Ou r aim was to evaluate in celiac patients the prevalence of surgery before d iagnosis. Two hundred forty-four adult celiac patients and 232 controls wer e retrospectively investigated for surgery before diagnosis of celiac disea se. The prevalence of surgery was increased in celiac patients versus contr ols (P = 0.001). Frequency of appendectomy (P = 0.0001), tonsillectomy (P = 0.009), and hernia repair (P = 0.05) were increased in celiac patients ver sus controls. Appendectomy was related to anemia (P = 0.006) and abdominal pain (P = 0.005); tonsillectomy was related to diarrhea (P = 0.02) and weig ht loss (P = 0,04). Appendectomy was elective in 73% of celiac patients and in 46% of controls. Cosmetic surgery was increased in celiac patients vers us controls (P = 0.058). In conclusions, surgery before celiac disease diag nosis is increased in celiac patients compared to controls, as a result of doctors' misdiagnosis and/or poor health status, which increases the demand for medical intervention. The frequency of cosmetic surgery in celiac pati ents may be related to impaired psychological profile of patients.