Abstract

Objective: This study aimed to measure the interval between initial symptom onset and confirmed diagnosis in symptomatic children with celiac disease (CD) from the Madinah region, and to identify factors contributing to prolonged diagnostic delay.
Methods: This retrospective cross-sectional study included 81 pediatric patients (≤19 years) with confirmed CD attending the gastroenterology clinic at the Maternity and Children Hospital, King Salman Bin Abdulaziz Medical City, Madinah, Saudi Arabia. Data were obtained via an online questionnaire or phone interview for cases diagnosed with CD between 2020 and 2025.
Results: The mean diagnostic delay from symptom onset was 5.4 ± 3.5 and 1.3 ± 1.8 years from the first medical visit. Children aged above 9 years experienced significantly longer delays. Diagnostic delay varied by symptom type, being longest for growth disorder symptoms (8.6 ± 2.6 years) and shortest for skin-related symptoms (1.9 ± 3.0 years; p-value = 0.01).
Conclusion: Diagnostic delay in pediatric patients with CD was considerable, particularly among older children and those presenting with growth disorders. Age at presentation was the only factor significantly associated with longer delay, highlighting the need for earlier recognition and prompt diagnosis to improve outcomes and quality of life.

Key words: Celiac disease, diagnostic delay, pediatric population, Saudi Arabia, Madinah region, gluten-free diet