Columbia University's Medical Center has recently announced that a low-adherence to biopsy guidelines affects the rate and accuracy of Celiac disease diagnoses in the United States. Where professional guidelines recommend a minimum of 4 samples from the small intestine, the study (published in the July 2011 issue of Gastrointestinal Endoscopy) found that only 35% of patients and procedures met this recommendation. With biopsy as the primary tool for diagnosing Celiac Disease, it does not seem surprising, then, that this disease is so incredibly under- and misdiagnosed. Why 4 samples? Because Celiac disease effects the intestine in patches, not unversally -- and "adhering to the recommendation of submitting at least four specimens more than doubled the diagnosis rate of celiac disease... Even when physicians indicated that they were suspicious of celiac (e.g., when patients had positive celiac disease blood tests), fewer than 40 percent of patients had at least four specimens submitted; the diagnosis was increased sevenfold when the guidelines were followed."
Affecting almost 1% of the population in the United States, Celiac disease is an autoimmune disease triggered by the ingestion of gluten, a protein in wheat, barley and rye.