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Question about the science behind the biopsy


Arduaine

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Arduaine Apprentice

Hi all,

 

I have some questions about the logic behind the biopsy... if it can take months or years to heal from celiac, surely damage would still show up even if you hadn't recently completed a gluten challenge and had only recently gone gluten free?

Is the definition of celiac damage to the villi + evidence of antibodies? And anything else is ibd or Ibs? 

. I have been gluten free for about 9 months and have seen dramatic improvement in my neurological symptoms and gi stuff but had a series of cross contamination accidents in the space of two weeks and still suffering a month later.

Would it be worth undertaking a endoscopy right now while I'm feeling crappy?

 

 Im currently weighing up the merits of undergoing the scheduled challenge in Feb which they recommend a month of eating gluten before. 

I just don't want to do unnecessary damage and don't feel convinced by the logic of the biopsy when it only seems to rule things in rather than out? If that makes sense. 

I did a previous gluten challenge for two weeks with a negative blood test  results and another one two weeks ago just in case which was also negative. 

I'm not sure if I am celiac or NCgs but I'm pretty convinced gluten is the enemy as my neurological symptoms have completely resolved giving up gluten but are back mildly after the challenge and currently with the cc. 

Any info appreciated! 

 

 

 

 

 

 


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kareng Grand Master
34 minutes ago, Arduaine said:

Hi all,

 

I have some questions about the logic behind the biopsy... if it can take months or years to heal from celiac, surely damage would still show up even if you hadn't recently completed a gluten challenge and had only recently gone gluten free?

Is the definition of celiac damage to the villi + evidence of antibodies? And anything else is ibd or Ibs? 

. I have been gluten free for about 9 months and have seen dramatic improvement in my neurological symptoms and gi stuff but had a series of cross contamination accidents in the space of two weeks and still suffering a month later.

Would it be worth undertaking a endoscopy right now while I'm feeling crappy?

 

 Im currently weighing up the merits of undergoing the scheduled challenge in Feb which they recommend a month of eating gluten before. 

I just don't want to do unnecessary damage and don't feel convinced by the logic of the biopsy when it only seems to rule things in rather than out? If that makes sense. 

I did a previous gluten challenge for two weeks with a negative blood test  results and another one two weeks ago just in case which was also negative. 

I'm not sure if I am celiac or NCgs but I'm pretty convinced gluten is the enemy as my neurological symptoms have completely resolved giving up gluten but are back mildly after the challenge and currently with the cc. 

Any info appreciated! 

 

 

 

 

 

 

Two weeks is usually not long enough of a gluten challenge for a blood test.  The antibodies are made in the small intestine and it can take a while for a body to make enough of them to show up in the blood stream in levels that can be detected with current testing.

With the biopsy - Celiac damage is not consistent.  What I mean is that the whole small intestine doesn't have equal damage.  The small intestine is around 16 feet long - so if you only have, for example,  20% damage, it is easy for a doctor to miss it when biopsying. 

 

Sure, it is possible to have a positive blood test or biopsy after months on the gluten-free diet. Depends on the person's immune system, amount of damage,  how long they have had Celiac, etc.  But I wouldn't want to bet my health on the fact that there might not be enough antibodies or damage after 9 months gluten-free.

If you get a negative right now - how would that effect you?  Would you still be strictly gluten-free for life like a Celiac must be?  Or do you need a diagnosis?  I see lots of un-tested people who go gluten-free and feel better  but they can't stick with it.  Once they feel better they go back to eating gluten.  they say they aren't Celiac so it doesn't matter (really they have no idea if they actually have Celiac or not)

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