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Celiac disease underdiagnosed due to low biopsy rates during endoscopy - Insidermedicine

Scott Adams

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Scott Adams
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Insidermedicine

From New York - Celiac disease is undiagnosed due to low rates of biopsy, according to a report published in Gastrointestinal Endoscopy. Researchers found that only 43% of 13000 patients who underwent endoscopy for celiac disease had a biopsy taken ...

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    • Scott Adams
      Endoscopy

      By Scott Adams · Posted

      Given your history of a high TTG (167) that decreased to 16 on a gluten-free diet, along with genetic confirmation of celiac disease, it’s likely the negative biopsy is a false negative due to not eating gluten before the endoscopy. Gluten is necessary to trigger the intestinal damage seen in celiac disease, and avoiding it can lead to healing and a normal biopsy despite ongoing immune activity (reflected in your still-elevated TTG). The inflammation observed during the endoscopy (“diffuse moderately erythematous mucosa”) could be residual damage, mild ongoing inflammation, or another condition like peptic duodenitis, but it’s consistent with celiac disease in context. Continued positive blood markers suggest ongoing gluten exposure, possibly from cross-contamination or hidden sources. Strict adherence to a gluten-free diet and follow-up testing are key to managing symptoms and reducing inflammation. Discuss these findings with your doctor to confirm the diagnosis and refine your dietary approach. 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.):    
    • Scott Adams
      Biopsy results after 1,5 gfd

      By Scott Adams · Posted

      Yes, it sounds like great progress, but what was the time frame between the two endoscopies? 
    • Scott Adams
      Help with results

      By Scott Adams · Posted

      Your symptoms—headaches, dizziness, nausea, irregular bowel movements, anemia, and menstrual changes—along with a family history of celiac disease, strongly suggest celiac disease could be the cause. The mild duodenal changes seen in your biopsy are consistent with early or mild celiac disease, though they could also be due to other factors. The improvement in bowel movements after cutting out gluten is a positive sign, but other symptoms like headaches and dizziness may take longer to resolve as your body heals. It’s important to continue a strict gluten-free diet and discuss further testing, such as celiac antibody blood tests or a follow-up biopsy, with your doctor to confirm the diagnosis. Many people experience a gradual improvement in symptoms over weeks to months, so patience and strict adherence to the diet are key. You’re not alone in this process, and support from celiac communities can be very helpful. 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.):    
    • Scott Adams
      For people with celiac disease and corn intolerance from it: Is salt still okay for most people?

      By Scott Adams · Posted

      For people with celiac disease and corn intolerance, most salts, including table salt with dextrose, are generally safe in small amounts, as the dextrose is typically highly processed and unlikely to contain problematic corn proteins. However, if you’re highly sensitive, you might consider switching to pure kosher or Himalayan salt, which don’t contain additives. While bringing your own salt to restaurants or avoiding seasoned foods can feel overwhelming, it’s a practical step if you’re concerned. Many people with corn intolerance tolerate trace amounts of dextrose in salt without issues, but individual sensitivity varies. If your current salt isn’t causing symptoms, it’s likely fine to continue using it, especially given your financial constraints and the challenges of managing dietary restrictions. Focus on what works for you and prioritize avoiding larger sources of corn, like cornstarch.
    • Scott Adams
      Stomach pains etc 2 weeks after start of gluten-free diet

      By Scott Adams · Posted

      Your daughter’s ongoing stomach pains two weeks into a gluten-free diet could be due to her body still healing after months of gluten exposure, as recovery from celiac disease can take time. Her inconsistent eating habits and possible eating disorder behaviors may also delay healing. While she’s now eating gluten-free snacks, her limited intake and emotional withdrawal complicate the process. It’s positive that she’s trying, but recovery may take weeks to months. Addressing her depression and mental health is crucial, as celiac disease can impact mood, and proper nutrition may help. Patience and support are key, but if symptoms persist, consult her doctor to rule out accidental gluten exposure or other issues. Many people with celiac disease, especially those who are in the 0-2 year range of their recovery, have additional food intolerance issues which could be temporary. To figure this out you may need to keep a food diary and do an elimination diet over a few months. Some common food intolerance issues are dairy/casein, eggs, corn, oats, and soy. The good news is that after your gut heals (for most people who are 100% gluten-free this will take several months to two years) you may be able to slowly add some these items back into your diet after the damaged villi heal.  
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