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Adult celiac disease, or gluten-sensitive enteropathy, is con-sidered rare in the United States (1). On the basis of datafrom Olmsted County, Minnesota, the clinical prevalence ofceliac disease in 1991 was considered to be 1 in 4600 of thepopulation (1). In Europe, where the disease is consideredcommon, serological screening studies have demonstratedthe prevalence of celiac disease to be between 1 in 250 and1 in 300 of the general population (2, 3). In NorthernIreland, the prevalence is even greater, 1 in 122 (4). A recentstudy from Baltimore that screened healthy blood donors forantiendomysial antibodies revealed a prevalence rate of 1 in 250 (5), similar to the European experience. The reason forthe lack of recognition and diagnosis of celiac disease in theUnited States is unclear (6 – 8). In view of the lack of current data on the clinical spectrum of celiac disease in the United States, we used a question-naire to obtain clinical information from a large number ofadults with celiac disease. We also attempted to determinefrom this questionnaire the impact of the low rate of recog-nition of celiac disease in the United States.