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Exact Details Of Endocscopic Biopsy


tendyourspirit

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tendyourspirit Newbie

Hi all, I hope you can help me in a hurry. It's been so long since I went through my biopsy that I cannot recall the appropriate methodology for the endoscopy. My mom is having an endoscopy for another reason but had bloodwork done last week that indicated that it might be prudent to check for celiac disease/villi damage. Anyhow I am fairly confident that her GI is not too knowledgable in this area and she won't switch her procedure at this point to someone in the area who is more knowledgable with celiac disease, but she is willing to have her GI pull the biopsy for celiac disease. So now I need to give her very specific information as to what to give to him re: what needs to be done for a proper biopsy. Even if he knows what to do, if nothing else, it will help to educate her. For some reason despite my surfing and net abilities I can't seem to pull this information off the net. Can anyone help me out here? She needs to call him ASAP and so any input would be appreicated.

It's great to finally join y'all. I'm a newbie here.

Thanks so much!

Andrea


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lovegrov Collaborator

I don't think I have all the details you need but I DO know that he needs to take something 8-10 samples from various areas of the small bowel. Damage can be spotty and if you take just 2 or 3 samples you can miss it. If he doesn't know what he's looking for he needs to let somebody with more expertise read the slides.

richard

gf4life Enthusiast

One thing they need to do when they take the biopsies (and most doctors don't do this) is to look at the tissue samples on the cellular level. I think it is called a celiac disease-3 stain. They can then count the number of lymphocytes (anything over 20 is conscidered celiac disease). This would only need to be done in the absence of visible damage to the villi, but it needs to be specially requested by the doctor or the lab won't do it.

I found this out too late, and since I had no visible damage I do not have the diagnosis. I will NOT do another gluten challenge (the first one was horrible) and so I will have to wait until they accept Enterolab in the mainstream medical field.

God bless,

Mariann

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    • trents
      Let me hasten to add that if you will be undergoing an endoscopy/biopsy, it is critical that you do not begin efforts to reduce gluten beforehand. Doing so will render the results invalid as it will allow the small bowel lining to heal and, therefore, obscure the damage done by celiac disease which is what the biopsy is looking for.
    • Scott Adams
      This article, and the comments below it, may be helpful:    
    • Scott Adams
      That’s a really tough situation. A few key points: as mentioned, a gluten challenge does require daily gluten for several weeks to make blood tests meaningful, but negative tests after limited exposure aren’t reliable. Dermatitis herpetiformis can also be tricky to diagnose unless the biopsy is taken from normal-looking skin next to a lesion. Some people with celiac or DH don’t react every time they’re exposed, so lack of symptoms doesn’t rule it out. Given your history and family cancer risk, this is something I’d strongly discuss with a celiac-experienced gastroenterologist or dermatologist before attempting a challenge on your own, so risks and benefits are clearly weighed.
    • Greymo
      https://celiac.org/glutenexposuremarkers/    yes, two hours after accidents ingesting gluten I am vomiting and then diarrhea- then exhaustion and a headache. see the article above- There is research that shows our reactions.
    • trents
      Concerning the EMA positive result, the EMA was the original blood test developed to detect celiac disease and has largely been replaced by the tTG-IGA which has a similar reliability confidence but is much less expensive to run. Yes, a positive EMA is very strong evidence of celiac disease but not foolproof. In the UK, a tTG-IGA score that is 10x normal or greater will often result in foregoing the endoscopy/biopsy. Weaker positives on the tTG-IGA still trigger the endoscopy/biopsy. That protocol is being considered in the US but is not yet in place.
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