No Biopsy Needed to Accurately Diagnose Celiac Disease in Nearly All Adults

Scott,

Thanks for that article! Kudos to Celiac.com

Dr. Hyman advocated this strategy nearly 10 years ago.

https://www.huffpost.com/entry/gluten-what-you-dont-know_b_379089

It has only taken another 10 years for research to confirm itself.

I just hope it doesn't take another 10 years to make it down to the clinical level.

I have always been glad my doctor knew enough to confirm my diagnosis without biopsy.

I was lucky I was not the first Celiac patient he had.....so he was well trained by other Celiac's in his practice! by the time he diagnosed by Serology alone....

Dr. Hyman said quoting

"We can no longer say that. Positive is positive and, as with all illness, there is a continuum of disease, from mild gluten sensitivity to full-blown celiac disease. If your antibodies are elevated, you should go off gluten and test to see if it is leading to your health problems."

And now researchers are again confirming themselves 10 years later!

I hope this is end of Endoscopy....but it won't probably won't be!  But at least it is a good start!

I hope this is helpful but it is not medical advise.

Posterboy,

Great potential. Its would create a strong possibility of testing children early. Hopefully free, we only need universal healthcare now.  A for profit healthcare severely limits care for celiacs. I could be wrong. How would my celiacs respond. 

This is good news for positive tests.  But what about false negative cases (like myself many years ago)... I was told then (thankfully) that a biopsy was needed to assess with certainty.  Seems this article should point this out? 

The article is just a summary of the published research. We typically don't inject other ideas or topics into our research summaries, but we do that when doing our own original articles that are not just summaries of research.

7 hours ago, Guest Doug said:

This is good news for positive tests.  But what about false negative cases (like myself many years ago)... I was told then (thankfully) that a biopsy was needed to assess with certainty.  Seems this article should point this out? 

Doug,

FWIW they now have better diagnostic tests than they did several years ago....

It might be awhile for it reaches clinical practice but they can now tell the difference between Celiac disease and NCGS using newly developed diagnostic tests.

It was discovered just this year...

There is probably no reason for "a biopsy" proven diagnosis anymore today....

But I don't expect this new research to be applied at the clinical level.....for another 10+ years....because we always do....what we always did!

It takes "a generation" IE another generation to pickup the new ways of doing things.....even if it is more advanced!

I have always felt lucky to have been diagnosed with blood tests alone!

But if someone still feels they need a biopsy "proven" diagnosis.....those procedures are still widely available.

I hope this is helpful but it is not medical advice.

Posterboy,

My niece was diagnosed despite a negative biopsy because -

1 - her blood test numbers were very high (I don't know which tests) and 

2 - she has celiac on both sides of her family - her father and her maternal aunt (me)

She just didn't have to go through 10+ years of damage to her villi before she was diagnosed.  She was given the blood test for celiac the first time she saw a doctor with her symptoms because of the strong family history. 

This is great news my husband was diagnosed about ten yrs ago. Antibodies were off the charts but doc insisted he have a biopsy to confirm. He also wanted him to remain eating gluten until time of biopsy. Of course my husband stopped eating gluten immediately, not wanting to do any further damage. It took about 3 months before biopsy was done and at that time he was 3b on the marsh scale. If he would have continued to eat the gluten over this time period I'm sure more damage would have been done to his stomach. The sooner you find out the better. He was rapidly loosing weight and extremely low iron levels. I was watching him waste away so even one more day of gluten consumption was very serious in regards to his health. The sooner you know the better before your faced with stomach cancer or some other serious problem. Doctors really need to pay more attention to celiac we were on a 6 year journey before we found out what was wrong. I think about how much difference this would have made in his recovery if we had only know sooner. Even with a strict gluten and dairy and starch free diet and peptide injections and the help of a great natroupath my husband still has some issues. If not found early celiac can be a struggle health wise. I wish everyone were able to have antibody tests done before they are faced with this condition. Many people walking around today have no idea that this is happening to them because many doctors don't have a clue about the severity or how prevalent this is.  Thank you to all the people who are trying to make a difference.

This has been my GI doctor's approach for some  time. My level were quite high and no biopsy was needed. So why is it that with every clinical trial I see recruiting participants,  they require biopsy confirmed diagnosis in order to be eligible?   I certainly hope that changes soon. I would like to participate in many of them,  but am always excluded.  

On 12/19/2020 at 11:47 PM, AnonyousCda said:

Great potential. Its would create a strong possibility of testing children early. Hopefully free, we only need universal healthcare now.  A for profit healthcare severely limits care for celiacs. I could be wrong. How would my celiacs respond. 

I think universal healthcare would severely delay diagnosis for most people.  Children or adults presenting with non-specific abdominal "discomfort" would be last in line to be seen by what would definitely become scarce doctors.  I, personally had only unexplained weight loss.  My PCP referred me to a gastroenterologist who scheduled an endoscopy and colonoscopy sight unseen and they were done within 5 days of the referral.  An inflamed polyp led to standard celiac blood testing and I was diagnosed within a 10 days of the initial PCP visit.   There is no way that occurs in a universal health care scenario. 

Burgher, you raise a good point. My observation is that our European forum participants, who live under universal health care, consistently testify of the difficulty and the wait times of getting appointments with specialists for endoscopies. And your experience with the polyp reminds us that an endoscopy may have more value than just a means of confirming celiac disease. It may catch other, and sometimes serious, health threats.

15 hours ago, trents said:

Burgher, you raise a good point. My observation is that our European forum participants, who live under universal health care, consistently testify of the difficulty and the wait times of getting appointments with specialists for endoscopies. And your experience with the polyp reminds us that an endoscopy may have more value than just a means of confirming celiac disease. It may catch other, and sometimes serious, health threats.

This was the point I wanted to chime in with, too.  A biopsy solely to confirm celiac disease may not be needed, but an autoimmune disease increases the risk of other health issues.

On 12/19/2020 at 11:47 PM, AnonyousCda said:

Great potential. Its would create a strong possibility of testing children early. Hopefully free, we only need universal healthcare now.  A for profit healthcare severely limits care for celiacs. I could be wrong. How would my celiacs respond. 

First of all nothing is ever truly free and I am not sure that it is a for profit healthcare system that SEVERELY limits care for celiacs---the only treatment is a gluten free diet---where will you get free food!?