Marsh 1?

[karalisa78]

Has anyone else had a biopsy come back Marsh 1, and didn't have blood work beforehand? My biopsy indicated possible celiac with a score of Marsh 1. Patchy Mildly Erythematous Moucosa. Other than that, all looked ok in the stomach. I got my results last week and still have not heard from the doctor (even with messaging). The issue is I have been eating a low carb diet for weeks now, and on and off for years because I feel so much better. Now I'm reading I should eat gluten in case I have to do blood test, which I have been doing, but is there a chance I may not need to do this? Wondering what others experienced if their biopsy came back Marsh 1 but through endoscopy looking for reflux?

[Scott Adams]

How much daily gluten were you eating before the endoscopy? It sounds like you were not eating enough, which can lead to false-negative results (although it sounds like you may still have a positive result).

Here is more info about how to do a gluten challenge for a celiac disease blood panel, or for an endoscopy:

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"...in order to properly diagnose celiac disease based on serology and duodenal histology, doctors need patients to be on gluten-containing diets, even if they are causing symptoms, and this is called a "gluten challenge."

• Eat gluten prior to celiac disease blood tests: The amount and length of time can vary, but is somewhere between 2 slices of wheat bread daily for 6-8 weeks and 1/2 slice of wheat bread or 1 wheat cracker for 12 weeks 12 weeks;
• Eat gluten prior to the endoscopic biopsy procedure: 2 slices of wheat bread daily for at least 2 weeks;

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and this recent study recommends 4-6 slices of wheat bread per day:

 

 

[karalisa78]

Thank you! I've been reading this, but my endoscopy did come back positive,  Marsh 1. Not sure if I do blood tests next to confirm or if that will be my diagnosis. No started eating gluten again when I got the biopsy result on Wednesday,  but still am not sure what the standard is here and would really like to go back to not eating it. 😫

[Scott Adams]

Hopefully your doctor will clarify everything, but given your positive biopsy and symptoms that seem to be relieved when you go gluten-free, it's likely that you have celiac disease, although the normal protocol for diagnosis typically begins with a blood antibody panel, followed by an endoscopy. Let us know how it turns out!

After you get the ok to go gluten-free:

This article has some detailed information on how to be 100% gluten-free, so it may be helpful (be sure to also read the comments section.):