Welcome to the forum, @Dhruv! Many with celiac disease are asymptomatic. We call them "silent" celiacs. That doesn't mean they will always be asymptomatic, however. It could just mean their physical constitutions are stronger and providing more resistance to damage. Eventually, it will catch up to them if they continue to consume gluten and they will develop symptoms and health problems. Elevated liver enzymes, by the way, are a classic symptom of celiac disease. This is what eventually led to my own diagnosis over 20 years ago. Back then this was not so well known. To answer your questions: 1. If we do endoscopy and he comes negative , he will be positive or negative for celiac? I do not want to be mislead. Not necessarily but it is not likely that with his high tTG-IGA antibody count and elevated liver enzymes that there will be a negative biopsy.   2. In endoscopy do they check small intestines health? If any damage over the period due to not following gluten free diet? Yes and Yes.   3. What can cause in long run if he fail to follow gluten free diet if he is positive for celiac? Increasing damage to the lining of the small bowel which is where the nutrition in our food is absorbed. This usually leads to vitamin and nutrient malabsorption and medical problems related to that such as osteopenia/osteoporosis.   4. It's very difficult to keep him off chapati as that's the most source for his carbs. He does not like rice that much. Being india it's very hard for me too ,to keep him away from chapati.(wheat tortila) Difficult but it must be done if he has celiac disease. And at home I could still manage with bhakri/ or gluten free, but what when he goes on tour? If he has celiac disease, you must find a way to do this. If your son does have celiac disease, he must buy into the gluten free diet or your your efforts to put that in place will not be effective. He is a young man now and he needs to make his own decisions. Educating him on the dangers of ignoring the need to eat gluten free if he has celiac disease will be important. Being consistent with the gluten free diet will be important   5. Do you suggest endoscopy? I don't want to poke him if it's not required. Yes. The endoscopy with biopsy is considered the gold standard of celiac disease diagnosis. ________________________________________________________________________________________________________________________________________________________________________________________ When I consider your total narrative, it seems to me his body may be flirting with celiac disease. As he is healthy, young and fit, he may be fighting it off at times and going back and forth. But his high tTG-IGA score indicates there is a problem and a problem that is at least simmering. At this point in time, I would guess he is a silent celiac.

, I m writing this email for my 18 years old son. We are resident in USA from past 18 years. My son is born in India, and I got him here when he was 3 months.   He has been playing cricket since he is 4 years. In 2015 we went to india for a vacation, there he had severe stomach pain for 10 days, we went to hospital and they found out gastro! He got all ok, since then he was having stomach pain when he eats bread, only bread not other wheat recipes. Hence we saw GI to make sure,they did bloodwork and diagnosis was celiac weak postive, so they decided to do endoscopy to make sure hence got endoscopy done, endoscopy came negative so Doctor did not inform us about celiac! Although its was shoing weak positive,But after that luckily he started having regular bowl moments which he was bit off earlier, then his appetite got better, he never complained about any stomach issues. Now he is 18 and 5"8 tall and a good athlete. He is a national cricket player,  He is left arm spinner and righty batsman. He works out daily, goes for practice and eats all healthy home made food, sometimes junk but very rare. Since 2021 his billirubin came high in every annual bloodwork, so this year's his Doctor asked us to visit GI, billirubin is 1.4 not more in last 3 years. It's not that high high but out of range.   Now we went to GI, he ran multiple test and now his bloodwork shows celiac positive. (tTG)IgA >100 (tTG)IgG 57 is result reflectting on bloodwork. He is totally asymptomatic, no complaints touch wood. His GI is recommended to go for another endoscopy to make sure. Being mom i m very stressed now. He has national selection next week in California, and don't know what to do. They asked him to stop gluten, we will definitely do but I need correct guidance on few questions.    1. If we do endoscopy and he comes negative , he will be positive or negative for celiac? I do not want to be mislead.   2. In endoscopy do they check small intestines health? If any damage over the period due to not following gluten free diet?   3. What can cause in long run if he fail to follow gluten free diet if he is positive for celiac?   4. It's very difficult to keep him off chapati as that's the most source for his carbs. He does not like rice that much. Being india it's very hard for me too ,to keep him away from chapati.(wheat tortila) And at home I could still manage with bhakri/ or gluten free, but what when he goes on tour?    5. Do you suggest endoscopy? I don't want to poke him if it's not required.   

That’s exactly what happens to me. I have been unconscious twice, vomiting afterwards for up to 9 hours and then the bone breaking chills start. I have never vomited while unconscious, thank god.  It’s an unusual presentation and my doctors were reluctant to think it was due to gluten ingestion. However, I know it was gluten as both times it happened within 2-2.5 hrs of eating. I no longer eat food that I haven’t prepared myself and it’s been 6 yrs since it happened.  I was behind the wheel once and was lucky to get off the road before I went out. I feel, and all my doctors reluctantly agree, that it’s a vasovagal reaction. If I can lay down it seems I don’t pass out but I still vomit and get the chills. It’s terrifying to say the least. I could have killed myself or others. I’m as strict as I can be for that reason. 

I assume you were on antibiotics for the E-coli infection? C-diff almost always is the result of prolonged and/or repeated antibiotic treatment. And there is a growing consensus that celiac disease is connected with gut dysbiosis which in turn is likely connected with first world overuse of antibiotics, preservatives and carbohydrate intensive/low nutrient diets. We are wrecking our gut microbiomes and those with genetic potential for celiac disease are reaping the fruit of it.  Can you repost post those antibody test scores but this time include the ranges for positive vs. negative. Each lab uses their own scale for these. There is no industry standard yet. Recently revised "gluten challenge" guidelines recommend the daily consumption of at least 10g of gluten (about the amount in 4-6 slices of wheat bread) for at least two weeks leading up to the antibody testing blood draw. To be sure, I would extend that to four weeks. Sadly, many practitioners neglect to (or don't know to) inform their patients of this before testing and so much testing done results in unclear outcomes. In your original post you mentioned lab analysis done from a colonoscopy. Colonoscopies cannot be used to diagnose celiac disease because they cannot get into the small bowel from the bottom end. Celiac disease causes damage to the lining of the small bowel which is accessed by an endoscopy. They take biopsies and send them to a lab for microscopic analysis.

A simple blood test should be done, and is usually the first step in diagnosing celiac disease. To do this you need to be eating lots of gluten daily for 6-8 weeks before doing the test. This article might be helpful. It breaks down each type of test, and what a positive results means in terms of the probability that you might have celiac disease. One test that always needs to be done is the IgA Levels/Deficiency Test (often called "Total IGA") because some people are naturally IGA deficient, and if this is the case, then certain blood tests for celiac disease might be false-negative, and other types of tests need to be done to make an accurate diagnosis. The article includes the "Mayo Clinic Protocol," which is the best overall protocol for results to be ~98% accurate.