Learn where to look for celiac disease

Internists are more likely than ever to treat patients with celiac disease, but the diagnosis is still often missed.

Years ago, celiac disease was thought to be a disorder that mainly affected children. Today, though, the average age at diagnosis is in the 50s, and the incidence in the U.S. has increased precipitously over the past several decades. As a result, internists are more likely than ever to treat patients with celiac disease, but the diagnosis is still often missed. Malabsorption, once considered the classic presentation, has given way to a wide range of symptoms, including constipation, anemia and fatigue, and physicians often don't consider celiac disease when evaluating affected patients. In our cover story, Paula S. Katz offers tips on diagnosis, treatment and follow-up from leading experts in the field.

Most physicians consider themselves well versed by now in the provisions of the Health Insurance Portability and Accountability Act (HIPAA). But they may not know as much about the new, related regulations included in the Health Information Technology for Economic and Clinical Health (HITECH) Act, signed into law last February. Under HITECH, breaches of privacy involving protected health information, such as a patient's name and Social Security number, carry much more expensive consequences. Janet Colwell details what physicians can do to protect themselves from penalties, including encrypting data and periodically conducting risk assessments of their practices.

This issue features the latest installment of Mindful Medicine, by Jerome Groopman, FACP, and Pamela Hartzband, FACP. This month, Drs. Groopman and Hartzband examine a case that took almost a year to diagnose correctly, largely because every doctor the patient saw thought her problem was related to his or her own specialty. Turn to page 5 for a discussion of how anchoring and availability contributed to a delayed diagnosis.

ACP's annual meeting, Internal Medicine 2010, takes place later this month in Toronto, Canada. ACP Internist staff will be on-site to bring you the latest in internal medicine news. Keep an eye on our blog, our Twitter feed and our daily e-mail dispatches for updates. If you're attending the meeting, stop by our booth in the exhibit hall to say hello.

If you have suggestions for future story topics, or cases to suggest for our Mindful Medicine column, e-mail us.


Jennifer Kearney-Strouse