Dáil Éireann Debate, Wednesday - 30 April 2014
792. Deputy Michael McCarthy asked the Minister for Health if he will provide an update on the guidelines and policy for coeliac disease diagnosis and management; and if he will make a statement on the matter. [18944/14]
View answer793. Deputy Michael McCarthy asked the Minister for Health his plans to introduce a screening programme for family members of those diagnosed with coeliac disease; and if he will make a statement on the matter. [18945/14]
View answerI propose to take Questions Nos. 792 and 793 together.
During the 1980s, before advances in testing for coeliac disease were made, the condition was mistakenly thought to be rare. However, coeliac disease is now known to be a common condition that affects approximately 1 in every 100 people. Women are two to three times more likely to develop coeliac disease than men. Cases of coeliac disease have been diagnosed in people of all ages.
In some cases, coeliac disease does not cause any noticeable symptoms, or it causes very mild symptoms. As a result, it is thought that at least 50% or possibly as many as 90% of cases are either undiagnosed or misdiagnosed as other digestive conditions, such as irritable bowel syndrome (IBS). The cause or causes of coeliac disease are unknown, but it is thought to be associated with a combination of genetic and environmental factors.
The guidelines for coeliac disease diagnosis and management currently in use in Ireland are the UK National Institute for Health and Care Excellence (NICE) guidelines, available for download at www.nice.org.uk.
Currently, screening for coeliac disease is not routinely carried out in Ireland. The simple blood test required is reasonably, but not completely, accurate. This means that routinely screening the entire population could produce a high number of false-positive results. In other words, people would be misdiagnosed as having coeliac disease when they did not have it. Therefore, screening for coeliac disease is usually only recommended for people with known risk factors for the condition, such as having a family history of the disease.
The Department of Health currently has no immediate plans to encourage targeted screening for coeliac disease. The international scientific literature, including a review against the criteria of the UK National Screening Committee, does not support the introduction of such a screening programme. Case finding by testing family members of patients diagnosed with the disease may be beneficial, particularly if family members manifest gastrointestinal or other symptoms. Primarily, the diagnosis and treatment of coeliac disease is broadly speaking managed by GPs in community services.
