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Do these biopsy results look like Celiac?


JenniK

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JenniK Contributor

I had an endoscopy and colonoscopy recently for chronic upper abdominal pain, which i thought was an ulcer, but they didn’t find one. I have been gluten-free for 3 or so (?) years now with presumed celiac. Gastroenterologist told me before procedures that he cannot (most likely) diagnose celiac because i was gluten-free for long time before seeing him. These results were posted by the pathologist, but I still haven’t had the Dr explain to me what he thinks. There seem to be several problem areas. Keep in mind that i was not knowingly eating gluten before endoscopy. A-C are gastric. D,E are colon. (A different part of the report also said “diffuse inflammation” and “reactive gastritis”. Thanks in advance

A. Fragments of small intestinal mucosa show normal villous architecture without intraepithelial lymphocytosis. A normal complement of
chronic inflammatory cells is present in the lamina propria without acute or granulomatous inflammation. runner's glands are present.
There is no metaplastic change, dysplasia, or malignancy.
B. Fragments of gastric antral and oxyntic mucosa show foveolar hyperplasia and smooth muscle hypertrophy and few foci of chronic
inflammatory cells within the lamina propria without acute or granulomatous inflammation. There is no intestinal metaplasia, dysplasia, or
malignancy. Features typical of Helicobacter pylori are not seen.
C. The sections show oxyntic type gastric mucosa with normal surface maturation and rare cystically dilated crypt lined by foveolar
epithelium. Normal minimal inflammatory infiltrates are present within the lamina propria. Acute or granulomatous inflammation is not
identified. Features of Helicobacter gastritis are not identified. Intestinal metaplasia, dysplasia, or malignancy are not identified.
imer
D. E. Colonic mucosa shows crypt hyperchromasia with elongation and pseudostratification of the nuclei. Features of high-grade
dysplasia are not identified.
Unless otherwise specified, formalin-fixed paraffin-embedded sections and all routine, IHC, or special stains are performed at


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Scott Adams Grand Master

The results seem negative for celiac disease, but I would agree with your doctor here with their conclusion that the results could not be used to diagnose celiac disease since you were gluten-free for so long before the endoscopy. 

Given that you've been gluten-free for so long, how important is it to you to have a formal diagnosis? Your private life and/or health insurance premiums my go higher with a diagnosis, so keep this in mind.

You could do this again after going at least two weeks on a gluten diet where you eat 2 slices of wheat bread daily beforehand. 

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    • Aretaeus Cappadocia
      I'm not saying this is what you have, but your description reminds me of Morgellons, which are not very well understood. Here is a review from a reputable source. If it seems similar to your experience, you could raise this question with your Dr.  https://my.clevelandclinic.org/health/diseases/morgellons-disease
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      Hi Trent, no dairy. Other than good quality butter. I have been lactose free for years. No corn, sugar, even seasonings and spices. I don't eat out. I cook my own food.
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      @nancydrewandtheceliacclue, are you consuming dairy? Not sure if dairy is part of the carnivore diet.
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      Hello Russ! Thank you so much for your reply.  I have not had an antibody test done, ever, relating to gluten. Last year I had an allergy test done via blood draw (as my insurance wouldn't cover the skin test) but this was for pollen and grasses, not food. Even on the blood test I had extremely high levels of reactions to each allergen. Could this seasonal allergy inflammation be contributing to my celiac inflammation? I am so careful, there is no way I could ingest gluten. For example, couple of months ago I tried a cough drop that says it was gluten free. I checked ingredients, it seemed fine. But just taking one of those caused me to have nausea, vomiting, and the same extreme abdominal pain. Have you ever heard of anyone else having symptoms like mine after being diagnosed celiac and strictly gluten free? The last episode I had like this was yesterday, after I ate a certified gluten-free coconut macaroon with a little chocolate on it. I have eaten coconut and chocolate before with no issue,  so I didn't see how I could all of a sudden have such a strong response. 
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