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Endoscopy Question
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Hello,

I have barrett's esophagus. My dr wants me to get scoped in January for it. During my consult I mentioned that going gluten free seemed to help my GI related issues. He said that celiac is very under diagnosed in this country (he said that Europe is catching on quicker than the US) and that he will biopsy me for celiac while he is doing the scope. I mentioned that I have been trying to go gluten free for about a month now and have heard that you need to continue to eat gluten for your test to be positive if you have celiac. His response was that blood tests are more sensitive to staying on the gluten diet while being tested and that not eating gluten for a couple months before the test would not interfere with the results, as reversal of celiac related symptoms takes quite awhile.

He said I was more than welcome to "gluten up" if I wanted to, but there was no need to since I have only been gluten free for about 2 months by the time I am tested.

I just wanted to get others opinions on it, as I don't plan on having another endoscopy for many years, so I want to do the test as accurate as I can.

Thanks,

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Do not listen to your doctor. ( Website sources at the end of this post. )

I experienced the same thing with mine and my nurse.

As for an "official" reason... Check out the National Institutes of Health's site on Celiac (.GOV)

It says that for all tests to be done accurately that a person cannot be gluten free before the tests are conducted. This is for all tests whether blood or scope.

I was gluten free for a week, and in the months prior to that I had tried being vegetarian and following a pescatarian diet. My symptoms had improved with these obviously.

I read that your body can start healing your intestine within 2 weeks.

After being gluten free, "glutening up" doesn't have much affect as the blood test is testing antibodies. These antibodies are built up over time by your body and subside if they are not needed.

I suggest a new doctor. I followed through with my endoscopy with my current doctor merely because we had met our deductible for the year and if it comes back positive well that was a cheap way to find out. I have another appointment with a doctor the celiac foundation recommended after the first of the year.

With all of that said, then another site says if you have been gluten free for a while and are doing fine, it probably isn't the best idea to reintroduce it to your system.

http://www.celiac.com/articles/22446/1/Do-I-have-to-Re-introduce-Gluten-in-Order-to-have-an-Accurate-Gluten-Sensitivity-Test-Done/Page1.html

NIH:

http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/

"Before being tested, one should continue to eat a 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 the disease is present."

This website:

http://www.celiac.com/articles/57/1/Interpretation-of-Celiac-Disease-Blood-Test-Results/Page1.html

"First, and this applies to any of the blood tests, you must currently be on a gluten containing diet for the tests to be accurate. antibodies are produced by the immune system in response to substances that the body perceives as threatening. The immune response that your body produces is its response to being exposed to gluten in the diet and its subsequent effect on the intestinal mucosa. If there is no gluten in the diet, then there is no response that we can measure. A brief change in diet will not have a noticeable effect. If you have been gluten free for a week or so, it will not make any great difference. The response might be marginally less but the difference is insignificant because the body has not had time to respond to the change. Conversely, if you have been gluten free for a protracted period of time and decide to be tested, a brief challenge of a couple of weeks is not enough to elicit a response and get an accurate test. "

Blood testing not very accurate:

http://www.celiac.com/articles/22310/1/Blood-Testing-for-Celiac-Disease-Isnt-Very-Accurate/Page1.html

At the end of it all. I would at least get a second opinion and perhaps contact the Celiac Foundation and ask them for their recommended doctors.

Celiac Foundation:

http://www.celiac.org/

( I'm not a doctor and my response shouldn't be taken as a medically certified expert advice. )

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I'll follow up with some endoscopy related reference materials:

http://glutenfreeworks.com/gluten-disorders/celiac-disease/diagnosis-and-testing/

http://www.mayoclinic.com/health/celiac-disease/DS00319

http://www.webmd.com/digestive-disorders/celiac-disease/celiac-disease-exams-and-tests

"If you have already started a gluten-free diet before these tests are done, the doctor may suggest you or your child eat a certain amount of gluten before the tests."

"How Long Does it Take to Heal After Removing Gluten?"

http://glutendoctors.blogspot.com/2010/04/healing-time-after-removing-gluten.html

( I'm not a doctor and my response shouldn't be taken as a medically certified expert advice. )

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yes , get some gluten down you . :blink: .Your gut will react if you have coeliacs and the Dr will be able to tell from the flattened Villi..

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Prior to my endescope I was advised that the minimum amount of time that you have to go back on gluten is 6 weeks but the general consensus on this forum seems to be 2 to 3 months. I know that it's a thought to go back on gluten but if you don't you could get a false negative.

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Prior to my endescope I was advised that the minimum amount of time that you have to go back on gluten is 6 weeks but the general consensus on this forum seems to be 2 to 3 months. I know that it's a thought to go back on gluten but if you don't you could get a false negative.

My daughter was glutened for only three weeks prior to her scope. Her doctor brought the pictures out to me and said, "yep, she's got it. I'll go ahead and test the biopsy but it's pretty much just a formality." I think it depends on the person's sensitivity?

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Yes, you're right thatwe're all different and respond in different ways. My daughter went gluten free following her positive blood test and when she went for her endescope they weren't happy that she'd been gluten free for a few weeks. However she was also told immediately that she had coeliac disease.

I think that all sort of factors might come into play - length of time undiagnosed, level of damage, amount of time gluten free and amount of time back on gluten etc.

My daughter had been at GPs, emergemcy rooms and hospital consultants 20 years. She was finally so ill that she was admitted to hospital where they ran 3 or 4 tests daily. On the seventh day one of these was for coeliac. I think in her case the damage was to such an extent that a couple of weeks gluten free still revealed damage.

I was 53 at diagnosis and it appears that I've been getting misdiagnosed since I was a school child. I went back on gluten, as requested by the GI,for seven weeks before endescopy. Although it was difficult and I couldn't have done it if I'd been working at the time, I thought it was worth doing it to lessen my chance of getting a false negative. I'll never know if I would've got a positive result if I'd remained gluten free.

At the end of day, I feel that it's a personal choice to be made by weighing up all the factors.

Hope that your daughter is improving now she's gluten free.

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