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How long to be gluten free before endoscopy?

Tico
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Tico Rookie
Tico
Posted

Hi,

I was diagnosed by bloodwork with celiacs the middle of June.  My doctor told me to start a gluten free diet and booked me for an endoscopy.  I have still not had my endoscopy, met with the surgeon the end of August, and he said it would be about 3 months before I would have my endoscopy.  I know I need to eat gluten before my endoscopy.  How long before should I have gluten?  I seem to get all kinds of different answers when I look.  My GP told me to eat gluten for 2 weeks before.  Is this correct or should I start eating gluten now?  Thanks

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Scott Adams Grand Master
Scott Adams
Posted
  • Solution

Welcome to the forum!

It's unfortunate that you have to wait so long for your endoscopy. Yes, technically your GP is correct, and the amount you should eat daily for 2 weeks beforehand should be equal or greater than 2 slices of wheat bread. You could also do this for a longer time just to be certain, but the minimum length of time for this would be 2 weeks.

trents Grand Master
trents
Posted

The Mayo Clinic guidelines for the pretest endoscopy/biopsy gluten challenge is a minimum of two weeks of daily consumption of two slices of wheat bread or the gluten equivalent.

Tico Rookie
Tico
Posted
  • Author

Thank you for the info!  I’ll have to check how much in advance they book the appointments and maybe do 3 - 4 weeks on gluten just to be certain.

trents Grand Master
trents
Posted
8 minutes ago, Tico said:

Thank you for the info!  I’ll have to check how much in advance they book the appointments and maybe do 3 - 4 weeks on gluten just to be certain.

That sounds like a good approach to me. I would make you aware, however that since you have been abstaining from gluten for about four months already you may find that you react more strongly to gluten than before. Over time, once we go gluten free we tend to lose whatever tolerance we used to have when consuming it regularly.

Tico Rookie
Tico
Posted
  • Author

I know, I am somewhat nervous about consuming gluten now, even though there are things I would like to eat.  It seems wrong to consume gluten after not having any for so long.  We will see how it goes!

trents Grand Master
trents
Posted

Understood. Maybe it would help to ease into it to to allow whatever acclimation to happen that can rather than jumping right to 2 slices of bread the first day back on gluten.

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Scott Adams Grand Master
Scott Adams
Posted
17 hours ago, Tico said:

I know, I am somewhat nervous about consuming gluten now, even though there are things I would like to eat.  It seems wrong to consume gluten after not having any for so long.  We will see how it goes!

Let us know how things turn out. It sounds to me like you've already linked your symptoms with gluten consumption, so at the very least you likely are in the non-celiac gluten sensitive category and may need to remain gluten-free even if your test results turn out negative for celiac disease (there is no test yet for NCGS).

Tico Rookie
Tico
Posted
  • Author

I do believe I have celiacs.  I really didn’t have many symptoms prior, a bit of bloating and tiredness, but nothing significant.  My ferritin was low and would not go up to normal even with supplements which is why the Doctor ordered the tests.  My bloodwork came back with Tissue Transglutaminase IgA positive and high 320, normal is <7.0.  I just want to get an accurate result from the endoscopy.  I phoned this morning, but they still are unsure when it will be.  I will let you know how it goes.  

trents Grand Master
trents
Posted

With a tTG-IGA that high I wouldn't have much doubt you have celiac disease. Most of the other causes of high tTG-IGA seem to give marginal positives.

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    • trents
      Taking Probiotics but Still Getting Sick After Gluten – Advice?

      By trents · Posted

      NCGS does not cause damage to the small bowel villi so, if indeed you were not skimping on gluten when you had the antibody blood testing done, it is likely you have celiac disease.
    • Scott Adams
      Taking Probiotics but Still Getting Sick After Gluten – Advice?

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      I will assume you did the gluten challenge properly and were eating a lot of gluten daily for 6-8 weeks before your test, but if not, that could be the issue. You can still have celiac disease with negative blood test results, although it's not as common:  Clinical and genetic profile of patients with seronegative coeliac disease: the natural history and response to gluten-free diet: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606118/  Seronegative Celiac Disease - A Challenging Case: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9441776/  Enteropathies with villous atrophy but negative coeliac serology in adults: current issues: https://pubmed.ncbi.nlm.nih.gov/34764141/  Approximately 10x more people have non-celiac gluten sensitivity than have celiac disease, but there isn’t yet a test for NCGS. If your symptoms go away on a gluten-free diet it would likely signal NCGS.
    • Xravith
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      I'm very confused... My blood test came out negative, I checked all antibodies. I suppose my Total IgA levels are normal (132 mg/dl), so the test should be reliable. Still, I'm not relieved as I can't tolerate even a single biscuit. I need to talk to my doctor about whether a duodenal biopsy is necessary. But it is really possible to have intestinal damage despite having a seronegative results? I have really strong symptoms, and I don't want to keep skipping university lectures or being bedridden at home.
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