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How Important Is The Biopsy?


kaysol

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kaysol Rookie

I am FINALLY meeting with a GI Dr. on Tues after waiting over a month to get in.

all 3 of my blood tests came back positive for celiac. My meeting Tuesday is just a consultation - they wouldnt even let me schedule the biopsy until I meet with him. I am so worried that it might take another month to get the biopsy done and I am getting sicker by the day. The past 3 weeks have been terrible, my stomach keeps gettting bigger and bigger (I actually look pregnant), I go between terrible consipation and then to diarehha and wake up at night with horrible pains in lower intestines. I guess my question is, if they can't get me in any time soon should I just say forget the biopsy and go with the blood test diagnosis? Could anything else make the the labs posative other than celiac? I am hating that I have to eat gluten and knowing that I could feel so much better. I feel like my life is on hold and I am so scared that something else could be wrong due to the disstention and horrible pains. My numbers on the blood work were all very high (IGA was 144 and my IGG was 111 and the other one was positive although I don't know the #'s also my cholesteral and iron were very low - 150 and 8). I am trying to prepare myself for the possibility that I might be told I have to eat gluten for another month or longer and I am wondereing if I would be safe saying forget it. Can these numbers mean anything else? I am so depressed and scared right now. I didnt really have many syptoms until recently but I feel like I keep gettting sicker by the day. Any advice would be much appreciated!

Thanks!

Stephanie


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Guest jhmom

Hi Stephanie, I am sorry you feel bad and are still going through the diagnosis process. It can be hard to make decisions about our health especially when we feel bad and just want to feel better. We trust our doctors and what they recommend but if it were me and my blood tests came back positive I would not go through with the biopsy, I would immediately begin the gluten-free diet. One thing to think about is sometimes blood test can be positive and biopsies can be negative and vice versa, so just keep that in mind.

Feel better soon :rolleyes: Take care

tarnalberry Community Regular

It's a personal decision. I am not biopsy diagnosed, but my doctor was willing to go on inconclusive blood tests and positive dietary challenge. But it's really a personal decision. You might have very little intestinal damage (though I'd doubt it from the low iron count), but at the least the blood tests say your immune system reacts to gluten.

SteveW Rookie

Going through the diagnosis process is not fun. It took me around 3 1/2 months of hell before I was confirmed to have Celiac Disease. But I also had a colonoscopy and was told I had some irritation in my colon and that I might have Crohns as well as Celiac. Turns out that I do have a mild case of Crohns. So I guess I'm saying in my case it was worth to get the biopsy. If you choose to go with a biopsy make sure that you get a colonoscopy at the same time. All these intestinal disorders have similar symptoms so the best way is to go in and check them all out.

CarolynM Newbie

Weighing in on the "skip the biopsy" side! With only positive antigliadin, we reluctantly went with the doc's recommendation and did the biopsy. ( I was ready to try gluten-free seeing obvious reactions to pastas, pancakes) It postponed getting by daughter healthy by nearly 3 months.

After waiting for an appointment then the biopsy. We were told everything was completely within normal range after the biopsy. She got worse and I decided to go gluten-free without the doc. It took only 3 days to see improvement - solid stools and sleeping much better. Now a month later, I wish I had skipped the anxiety of the biopsy and the $6000+, and still coming, in medical bills that thankfully, our insurance is paying 80%.

I say try your own test with a gluten-free diet. You can always go back to the doc for tests if you don't improve.

ryeanddiet Rookie

Hi Stephanie

I'd vote for 'get the diagnosis'. Several on the board have gotten relatively quick tests from enterolab and had the results accepted by their GI/GP, if your Dr won't confirm the diagnosis just with the blood test, ask if he/she would accept this.

I don't have that option living in Canada. I had positive blood so went gluten-free only (I felt better than I ever have in my life, all symptoms disappeared, all anemias turned around) to have the GI tell me 8 months later they wouldn't confirm celiac without the biopsy. I want the formal, medical diagnosis so Dr's will keep an eye out for associated illness, my children will get tested, etc.

I'm now back on gluten in preparation for the biopsy and am more sick than I was before. I know it's not fun but my opinion would be to get the diagnosis (unless you don't care and it's unbareable, in which case try to find a more sympathetic Dr and go gluten-free).

If your GI insists on a scope, there may be options. I'm paying to go to a higher end private clinic just so I don't have to wait the 9 months for the appt (I'm in Canada, public health care takes longer).

Best of luck. Fingers crossed.

jen

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    • CC90
      Thank you for responding.  I didn't intentionally reduce gluten prior to the endoscopy though I dont generally eat a lot of it due to the unpleasant symptoms. I was under the impression my TTG of 87.4 was very high, at least that's what my doctor said.  
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      Thank you.  I think what's confused me is that I assumed the biopsies would show damage due to my TTG being so high.   I have been looking into paying for the genetic testing.  I think I will do this.  If it shows I have the genes I will consider the repeat endoscopy.  If I haven't got the genetic susceptibility at least I will know and not go through another endoscopy unnecessarily.     I have been on 30mg lansoprazole daily for 3 years and my acid symptoms have not resolved.  Its miserable being in pain and not having a definite answer.  I have had transfusions for iron due to chronic low ferritin that doesn't resolve with tablets but I'm not sure about B vitamins.  
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    • trents
      Welcome to celiac.com, @cc90! Had you been experimenting with a gluten free or reduced gluten diet prior to getting the TTG and the endoscopy/biopsy? If so, it would have skewed the test results, including the endoscopy/biopsy, toward the negative range. Was the TTG-IGA the only blood test run for checking into celiac disease? Did they also do a Immunoglobulin A (IgA) (aka, "total IGA") test to check for IGA deficiency? This should always be run along with the TTG_IGA test. If you are IGA deficient, then the IGA tests such as the TTG will not be reliable.
    • CC90
      I'm really confused.  I've struggled with pain in right side of abdomen, head fog, nausea, acid reflix etc and have attended A&E on several occasions with no cause found (normal ultrasounds and CT). My GP ordered bloods.  TTG was 87.4 so I was referred for endoscopy.  Endoscopy was very traumatic but seemed worth it to have diagnosis confirmed.  Results have returned saying everything looks normal (7 biopsies taken) but they have arranged a repeat endoscopy to look at other areas of the bowel.  I really dont think I can go through the wait and traumatic ordeal again.  Is it likely I'm coeliac or not.  I was expecting confirmation but have been left more confused than ever.  
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