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Do these biopsy results look like Celiac?

JenniK
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JenniK Contributor
JenniK
Posted

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
Scott Adams
Posted

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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