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Going Off Gluten Before Biopsy


Luhts

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Luhts Newbie

Hi, newbie here!

I was just wondering why you go off gluten b/f the biopsy? To me, this would just be torture to have to start it up again and make yourself sick all over again. It this something that you are required to do?


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*lee-lee* Enthusiast

hi and welcome!

go OFF gluten before the biopsy? no, you need to continue consuming gluten until all your tests are complete. eliminating gluten from your diet will cause your body to begin the healing process and the damage may not be visible if you're off it for too long before the biopsy.

happygirl Collaborator

The damage is done to the intestines by eating gluten. When you stop eating gluten, your body begins to heal. The goal of someone with Celiac is to heal and have their intestines look 'normal' and not like Celiac.

If you are gluten free when you have the biopsy, it can provide misleading information - your report may look like a non-Celiac, when in fact, you are a healed Celiac.

You have to be eating gluten for the biopsies to be accurate.

"A gluten-free diet should not be started until all diagnostic tests are completed, as the withdrawal of gluten can change test results" from: Open Original Shared Link

"All diagnostic tests need to be performed while the patient is on a gluten-containing diet." from the NIH Consensus Statement on Celiac Open Original Shared Link

"Before being tested, one should continue to eat a regular diet that includes foods with gluten, such as breads and pastas. If a person stops eating foods with gluten before being tested, the results may be negative for celiac disease even if celiac disease is actually present." Open Original Shared Link

"A person seeking preliminary diagnosis of celiac disease must be consuming gluten. " Open Original Shared Link disease-diagnosis.php

"It is important to continue eating a normal, gluten-containing diet before being tested for celiac." Open Original Shared Link

Luhts Newbie

Thanks, that's a relief! A lot of the posts I have been reading on here led me to think after the blood test, you were supposed to go off gluten for a period of time, then reintroduce it for a period before going for the biopsy. Many posters seem to be talking about not eating enough gluten, or the extreme symptoms they experienced when re-introducing gluten to their systems...I did not want to go through that!

hawaiimama Apprentice

I was told to go off of it because the biopsy would take monhts. I ended up being gluten-free for 5 weeks before the biopsy which ended up negative. I suspect from a combo of bad biopsy and healing.

ravenwoodglass Mentor
Thanks, that's a relief! A lot of the posts I have been reading on here led me to think after the blood test, you were supposed to go off gluten for a period of time, then reintroduce it for a period before going for the biopsy. Many posters seem to be talking about not eating enough gluten, or the extreme symptoms they experienced when re-introducing gluten to their systems...I did not want to go through that!

There are some of us who don't show up in blood work. For us the big clue comes when an allergist,doctor or we ourselves eliminate it from our diets and then challenge. An allergist will tell you to stop a challenge as soon as you react. That was what mine did. His exact words when I called him to tell him the result of adding gluten back in and ask it I should keep eating was "Oh good heavens NO" Then I was sent to a GI doctor who of course wanted to prove what my body had already told me and he demanded another longer term challenge for the biopsy which had horrible results.

If you are going to do the biopsy for diagnosis you do not want to stop eating the stuff until after that is done. Do be sure though to give the diet a good strict try after the testing YOU choose to have is done. There are false negatives with biopsies for multiple reasons and the truest test is how you respond to the diet when done strictly.

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    • trents
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    • shell504
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    • trents
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    • trents
      Welcome to the forum, @shell504! The IGA 401mg/dl is not a test for celiac disease per se but a check to see if you are IGA deficient. People who are IGA deficient will produce celiac blood test antibody scores that are artificially low which can result in false negatives for the individual antibody tests such as the TTG IGA. You did not include reference ranges along with the test scores and since each laboratory uses custom reference range scales, we cannot comment with certainty, but from the sheer magnitude of the IGA score (401) it does not look like you are IGA deficient. And since there are no annotations indicating that the other test scores are out of range, it does not appear there is any antibody evidence that you have celiac disease. So, I think you are warranted in questioning your physician's dx of celiac disease. And it is also true that a colonoscopy cannot be used to dx celiac disease. The endoscopy with biopsy of the small bowel is the appropriate procedure for diagnosing celiac disease. But unless there is a positive in the antibody testing, there is usually no justification for doing the endoscopy/biopsy. Is this physician a PCP or a GI doc? I think I would ask for a second opinion. It seems as though this physician is not very knowledgeable about celiac disease diagnositcs. Having said all that, it may be that you suffer from NCGS (Non Celiac Gluten Sensitivity) rather than celiac disease. The two gluten disorders share many of the same GI symptoms. The difference is that NCGS does not damage the villous lining of the small bowel as does celiac disease. NCGS is 10x more common than celiac disease. The antidote for both is complete abstinence from gluten. Some experts believe NCGS can be a precursor to the development of celiac disease. There is not test for NCGS. Celiac disease must first be ruled out. So, if it becomes apparent that gluten is causing distress and testing rules out celiac disease, then the diagnosis would be NCGS. Hope this helps. 
    • shell504
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