有文献提示“美国约有140万人虽患有胃肠疾病，但却不知道自己有病。”我相信中国的情况也好不到哪里去。为何胃肠疾病难以发现？个人认为：一是大家对胃肠疾病重视程度不够；二则目前各医疗机构实施的健康检查套餐涉及诊察胃肠的手段或指标真不多（注：因为经济和检查不方便或痛苦，及技术要求，目前的健康检查尚未将胃肠内镜的检查纳入常规套餐）。因此，胃肠疾病往往难以发现也就不难理解了。正如美国疾病预防与控制中心建议的那样，我提醒年过50岁的男女两性均应自觉接受胃肠镜检查，并于每5年重复接受检查1次，以早期发现胃肠疾病，特别是癌症。

Most Americans With Celiac Disease Don't Realize It: Study

On the other hand, many without the disease needlessly follow gluten-free diets

THURSDAY, Aug. 2 (HealthDay News) -- New research suggests that 1.4 million Americans have celiac disease but don't realize it, while 1.6 million people are on gluten-free diets -- a treatment for celiac disease -- even though they might not need it.

The findings, which estimate that 1.8 million Americans have celiac disease -- an autoimmune condition -- suggest that a whopping 78 percent of sufferers don't realize they have the condition.

"This provides proof that the disease is common in the United States," said study co-author Dr. Joseph Murray, a gastroenterologist at the Mayo Clinic, in a clinic news release. "If you detect one person for every five or six [who have it], we aren't doing a very good job detecting celiac disease."

People with celiac disease have trouble digesting wheat, rye and barley. A gluten-free diet can help, but about 80 percent of people on such a diet haven't been diagnosed with celiac disease.

"There are a lot of people on a gluten-free diet, and it's not clear what the medical need for that is," Murray said. "It is important if someone thinks they have celiac disease that they be tested first before they go on the diet."

The researchers came to their conclusions by examining blood-test results and the findings of a national survey.

Celiac disease appears to be especially common in white people.

"Virtually all the individuals we found were non-Hispanic Caucasians," said study co-author Dr. Alberto Rubio-Tapia, a Mayo Clinic gastroenterologist, in the news release. But, he said, the results are head-scratching because research in Mexico has suggested celiac disease is common there.

The research was funded in part by the U.S. National Institutes of Health and the U.S. Centers for Disease Control and Prevention.

The study appears July 31 in the American Journal of Gastroenterology.

SOURCE: Mayo Clinic, news release, July 31, 2012