Help Please

[HebrewRose]

I recently had my antibody levels tested and all but my gliaden IgG were normal. IgG was 52 (ref 0-10). My family doctor tells me he's fairly sure I have celiac given my family history of the disease as well as my symptoms.

I'm concerned though because when I asked for a referal to a GI specialist for a biopsy, he told me that a biopsy was unneccessary and that a simple colonoscopy would do. He also told me to go ahead and begin a gluten-free regime. My GI appointment isn't for another month and a half, and I'm concerned that if I go gluten-free, my body will already be healing and will give inaccurate results. I have no idea what to do about this.

Any suggestions?

[Lisa]

Your doctor is ill informed. You are smart to question him. This is the test that you should have:

Anti-gliadin antibodies (AGA) both IgA and IgG

Anti-endomysial antibodies (EMA) - IgA

Anti-tissue transglutaminase antibodies (tTG) - IgA

Total IgA level.

Get a copy of your result and post then here. A colonoscopy will not detect Celiac, but it might be wise to have a base line test, especially if you have had issues. That is done through the small intestines with an endoscopy/biopsy, to test for damage due to Celiac, although, no current testing is conclusive.

It is important, should you pursue and endoscopy exam, you must remain on a full gluten diet. If you can accept a diagnosis, based on positive dietary results and your family history, you can begin the diet immediately. Many people here have taken that road.

We can't tell you what to do, only to arm you with facts to make your own decision.

[HebrewRose]

Your doctor is ill informed. You are smart to question him. This is the test that you should have:

Anti-gliadin antibodies (AGA) both IgA and IgG

Anti-endomysial antibodies (EMA) - IgA

Anti-tissue transglutaminase antibodies (tTG) - IgA

Total IgA level.

Get a copy of your result and post then here. A colonoscopy will not detect Celiac, but it might be wise to have a base line test, especially if you have had issues. That is done through the small intestines with an endoscopy/biopsy, to test for damage due to Celiac, although, no current testing is conclusive.

It is important, should you pursue and endoscopy exam, you must remain on a full gluten diet. If you can accept a diagnosis, based on positive dietary results and your family history, you can begin the diet immediately. Many people here have taken that road.

We can't tell you what to do, only to arm you with facts to make your own decision.

Thanks. Those are the tests I had, and like I said the only one that wasn't normal was the anti-gliadin IgG. But I was kind of suspicious about the colonoscopy. I appreciate your advice a lot though.

[sbj]

Best of luck getting a proper and accurate diagnosis. Sounds to me as if your intern is not well informed.

My opinion only and no substitute for a real doctor, you don't have celiac but might have a food allergy, Crohn's, or some other auto-immune disease. It therefore makes sense to have a colonososcopy (depends on your symptoms). Since you almost for sure do NOT have celiac you do not need a biopsy via endoscopy to confirm that. If you still think you have celiac - which is not likely given your test results - you can avoid the endoscopy and instead try a genetic test. If you're negative for the genes then you really have no possibility to acquire celiac.

This is the typical situation and I'm sure others would disagree. There are always exceptions but it makes sense, to me, to start out with the more likely stuff.

When IgA levels are normal (anti-endomysial IgA and anti-tissue transglutaminase IgA) this means that your body is not attacking itself because of gluten and you therefore don't have celiac. BUT, your IgG level is abnormal. This means that your body might be attacking gluten (as opposed to itself).

"Many normal individuals without CELIAC DISEASE will have an elevated antigliadin IgG, causing much confusion among physicians. If a patient

[sbj]

By the way:

"he told me that a biopsy was unneccessary and that a simple colonoscopy would do."

A biopsy via endoscopy is the the procedure that is relatively simple and mostly painless - at least it was for me.

A colonoscopy, on the other hand, is a very difficult thing to go through. It is by no means 'simple.' It takes all day to prepare, can't eat for a day plus, you are under a local anesthetic, you need a driver, and you have to sign releases in case you are injured. It's not simple and it's not easy.

If I were you I would maintain a normal diet until all of this testing is complete. I would not start the gluten-free diet unless I had to, or unless you really want to even if you don't have celiac. Your intern is probably recommending you stop eating gluten foods because of your family history and symptoms and NOT because of your test results. Remember, the high IgG levels don't necessarily mean you have a problem with wheat (the G in IgG does not stand for gluten). It could be some other food entirely causing your high IgG levels (or even a virus). You might still be able to enjoy wheat products! I'm hoping you can.