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How long to be gluten free before endoscopy?


Tico
Go to solution Solved by Scott Adams,

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Tico Rookie

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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  • Solution
Scott Adams Grand Master

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

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

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
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

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

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
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

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

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
      I would ask for a total IGA test (aka, Immunoglobulin A (IgA) and other names as well) to check for IGA deficiency. That test should always be ordered along with the TTG IGA. If someone is IGA deficient, their individual celiac IGA test scores will be artificially low which can result in false negatives. Make sure you are eating generous amounts of gluten leading up to any testing or diagnostic procedure for celiac disease to ensure validity of the results. 10g of gluten daily for a period of at least 2 weeks is what current guidelines are recommending. That's the amount of gluten found in about 4-6 slices of wheat bread.
    • jlp1999
      There was not a total IGA test done, those were the only two ordered. I would say I was consuming a normal amount of gluten, I am not a huge bread or baked goods eater
    • trents
      Were you consuming generous amounts of gluten in the weeks leading up to the blood draw for the antibody testing? And was there a Total IGA test done to test for IGA deficiency?
    • jlp1999
      Thank you for the reply. It was the TTG IGA that was within normal limits
    • trents
      Welcome to the forum, @jlp1999! Which IGA test do you refer to as being normal? TTG-IGA? Total IGA? DGP-IGA? Yes, any positive on an IGA or an IGG test can be due to something other than celiac disease and this is especially true of weak positives. Villous atrophy can also be cause by other things besides celiac disease such as some medications, parasitic infections and even some foods (especially dairy from an intolerance to the dairy protein casein). But the likelihood of that being the case is much less than it being caused by celiac disease.
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