Patient perceptions of the burden of coeliac disease and its treatment in the UK

Aliment Pharmacol Ther. 2009 May 15;29(10):1131-6. doi: 10.1111/j.1365-2036.2009.03983.x. Epub 2009 Feb 26.


Background: Coeliac disease affects about 1% of the population, with the majority being undetected. As a consequence, there have been calls for the introduction of screening. Before screening is given serious consideration, it is important to assess how acceptable early diagnoses and treatment would be.

Aim: To assess patients' views as to the diagnosis and treatment of disease.

Methods: Coeliac disease patients who had taken a gluten-free diet for at least 12 months (mean 60 months) were mailed a questionnaire. Coeliac patients presenting with typical classical symptoms were compared with those diagnosed without such symptoms.

Results: Overall, 83% (147/177) of coeliac patients returned the questionnaires. Two-thirds (68%, 101/147) reported that their dietary restrictions reduced their enjoyment of food; 46% (68/147) believed their food cost them more and estimated this to be an extra 10 pounds sterling (16 euros) per week. Of those reporting greater cost, 31 (21%) said this was a problem for them. Half (54%, 80/147) reported doing things they enjoyed less often because of their diet, with the most common activity sacrificed being dining out (n = 65). In spite of these findings, 81% (119/147) reported being pleased that they were diagnosed, with 66% (59/89) of cases with classical symptoms wishing they had been diagnosed earlier compared with 45% (23/51) of those without such symptoms (chi(2) = 6.0, P < .05). In contrast, 27% (14/51) of coeliacs diagnosed without classical symptoms regretted being diagnosed with their condition compared with 10% (9/89) of those with classical symptoms (chi(2) = 7.1, P < .01).

Conclusions: Even after several years of a gluten-free diet, many patients with coeliac disease regard it as a substantial burden, with a quarter of screen detected patients reporting regret at being diagnosed. Our findings question how acceptable screening for coeliac disease would be in people with minimal or no symptoms.

MeSH terms

  • Adult
  • Attitude to Health
  • Celiac Disease / diet therapy*
  • Celiac Disease / psychology
  • Diet, Gluten-Free / economics
  • Diet, Gluten-Free / psychology*
  • Female
  • Glutens / administration & dosage*
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance / psychology*
  • Patient Satisfaction / statistics & numerical data*
  • Quality of Life
  • Surveys and Questionnaires
  • United Kingdom


  • Glutens