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Gluten Challenge


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#16 Christine0125

 
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Posted 14 October 2012 - 12:26 PM

I was gluten light for 2 months then did a 2 week gluten challenge and that was plenty to show positive results on the bloodtest.
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#17 kareng

 
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Posted 14 October 2012 - 03:06 PM

This was on the of Chicago Celiac Center Facebook page. The first sentence was the original post and the second part was thier "comment" in response to a question. The only way to prove this is for you to go on Facebook and check it out, sorry.


'During a 12-week gluten challenge, only a cracker or a 1/2 slice of bread need be consumed each day.



The University of Chicago Celiac Disease Center A gluten challenge is used to trigger the immune system prior to testing (blood or biopsy) so that there are measurable results to test. It should be done only under the supervision of a medical professional, for severe results can mandate a shortened challenge.
October 10 at 11:47am · Like · 1'



When the U of Chicago Celiac ct sent me a postcard to remind me of the free screening this weekend, the card said a regular gluten diet for 3 months. Sorry, can't link to my kitchen counter. :D

I know for myself, I was gluten-free for 3 months and, while my antibodies had dropped dramatically, I was still "high". I would not say that is normal for everyone. I think the point of the "gluten challenge" is to make enough anitbodies or intestinal damage to show on the test you are having. I suspect that the Celiac center at Chicago is trying to give the most people the best chance of getting a positive test.

I did notice that they said to do the challenge with the supervision of a doctor. Hopefully, if the challenge is too, hard the doctor would see that and help you diagnose from there.

Edited to correct multiple typos. I guess the point of reading glasses is to wear them when typing and reading. ;0

Lert me edit this to say that they may have put this info on thier website, but I don't have the time right now to look. If I get a chance later, I will post a link, if I find one. They keep changing thier website, adding and deleteing.
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LTES

 
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#18 psawyer

 
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Posted 14 October 2012 - 03:30 PM

I have a question about a gluten challenge: Does anyone know if 4 weeks of eating gluten light would lead to a false negative on biopsy?

See, there is the question and it specifically asks using the explicit word, "biopsy."
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Peter
Diagnosis by biopsy of practically non-existent villi; gluten-free since July 2000.
Type 1 (autoimmune) diabetes diagnosed in March 1986
Markham, Ontario (borders on Toronto)

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#19 kareng

 
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Posted 14 October 2012 - 03:41 PM

I have no idea why so many are so adamantly going off on these tangents.
Several of us answered the orig Q. (The "Does anyone know" answer is "no, no one can be sure".)

The OP, Blevois, was already diagnosed by blood.
The topic of the thread is not about getting a dx by biopsy.


Ok. Your right. She didn't say "diagnosed" she asked if she would get a negative biopsy. Most of our info would say "diagnosed by a biopsy" because, really, who would just do the endo for fun, not wanting more diagnostic info? Why would she care about a false negative if she didn't think it was for diagnosis? More important : Why are we fighting over her choice of wording?

How many people that have been on here , over the years, have had postive blood but a negative biposy? How many of them have been told, you don't have Celiac with a pos blood and a negative biopsy? My answer- an unscientific "lots". If someone had the time, they could go back and complie the numbers.

I believe my info from the Univ of Chicago FB referred to both blood and endo. I'll go up and re-read it to see.
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#20 GottaSki

 
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Posted 14 October 2012 - 03:45 PM

I have a question about a gluten challenge: Does anyone know if 4 weeks of eating gluten light would lead to a false negative on biopsy?

No one can know whether eating gluten light would lead to a false negative - there are unknown factors in each diagnosis. We can only suggest what we believe gives the best possible chance for accurate testing results.

As everyone can read in all the recent posts regarding "Gluten Challenge" there are varying opinions of the procedures needed to give the best possible chance for accurate blood tests and endoscopic biopsy - even among the top celiac research centers. This is not likely to change quickly.

Can we present our personal opinion of the best course of action for folks and leave it up to them to decide which makes the most sense for their situation?
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-Lisa

Undiagnosed Celiac Disease ~ 43 years

3/26/09 gluten-free - dignosed celiac - blood 3/3/09, biopsy 3/26/09, double DQ2 / single DQ8 positive

10/25/13 - MCAD

Health history since celiac diagnosis became too long -- moved to the "about me" section of my profile

My children and I all have multiple copies of the genes for Celiac Disease, along with large variety of symptoms/resolution gluten-free

Current tally from me, three kids and two grands: 4 diagnosed with Celiac Disease, 2 NCGS

Get PROPERLY tested BEFORE REMOVING GLUTEN.

ALWAYS independently research health related information found on internet forums/blogs.

"LTES" a Gem :)


#21 GottaSki

 
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Posted 14 October 2012 - 04:15 PM

Here is the review of celiac center recommendations for gluten challenge that I posted in a similar thread two months ago:

UCSD = 4-6 weeks, no specific amount of gluten was referenced

University of Chicago = 12 weeks, 1/2 slice gluten bread per day

Beth Israel = 4-6 weeks with increasing amounts of gluten

Mayo Clinic and University of Maryland = could not find a time associated with challenge - maybe they don't want to put it in writing because it remains unclear

Did find one reference for Mayo 2010 that referenced 4 weeks on 4 slices of whole wheat bread.


And we'll add this response from University of Maryland provided by Squirmingitch:

Unfortunately there is no accurate answer to these questions. It tends to differ person to person. What we usually recommend is 6-8 weeks of eating gluten before testing. However, if you have been on a gluten-free diet for a year or more, then more time may be needed – so yes, the length of time on the gluten-free diet matters. As for how much gluten each day - base it on how much you can tolerate, but at least the equivalence of 2 slices of gluten-containing bread per day.
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-Lisa

Undiagnosed Celiac Disease ~ 43 years

3/26/09 gluten-free - dignosed celiac - blood 3/3/09, biopsy 3/26/09, double DQ2 / single DQ8 positive

10/25/13 - MCAD

Health history since celiac diagnosis became too long -- moved to the "about me" section of my profile

My children and I all have multiple copies of the genes for Celiac Disease, along with large variety of symptoms/resolution gluten-free

Current tally from me, three kids and two grands: 4 diagnosed with Celiac Disease, 2 NCGS

Get PROPERLY tested BEFORE REMOVING GLUTEN.

ALWAYS independently research health related information found on internet forums/blogs.

"LTES" a Gem :)


#22 GottaSki

 
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Posted 14 October 2012 - 04:39 PM

Ok then, before I go out, what would YOU hypothetically want your own Dr to say w/ "very high" positive bloods and the hypothetical negative biopsy?

Didn't most of the 1st few replies comment that the OP's blood results should be enough to dx celiac? Along that path, the endoscopy is post-diagnostic. Confirms if pos, but ignored if neg isn't a dx flowchart.

Until all doctors are uniform in following the flowchart you state, there can be no assumption of what each doctor will do.

I would love to live in a world where each and every doctor would diagnose based on positive blood work regardless of biopsy result. I just don't think that is our current reality.

edited for typo
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-Lisa

Undiagnosed Celiac Disease ~ 43 years

3/26/09 gluten-free - dignosed celiac - blood 3/3/09, biopsy 3/26/09, double DQ2 / single DQ8 positive

10/25/13 - MCAD

Health history since celiac diagnosis became too long -- moved to the "about me" section of my profile

My children and I all have multiple copies of the genes for Celiac Disease, along with large variety of symptoms/resolution gluten-free

Current tally from me, three kids and two grands: 4 diagnosed with Celiac Disease, 2 NCGS

Get PROPERLY tested BEFORE REMOVING GLUTEN.

ALWAYS independently research health related information found on internet forums/blogs.

"LTES" a Gem :)


#23 Lisa

 
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Posted 14 October 2012 - 04:46 PM

I am new to the forum and have learned so much already. Thank you to all who have shared their experiences and knowledge I have a question about a gluten challenge: Does anyone know if 4 weeks of eating gluten light would lead to a false negative on biopsy?

I have a positive antibody test (Ttg IGA) and was advised by the allergist that ordered the test to go gluten free. This was approximately 4 weeks ago. I went gluten free but not strictly so. I ate many items which may have been cross contaminated as well as eating out with friends on numerous occasions. In reality it was more like I was eating gluten light. My symptoms improved greatly, but I still had some residual pain. I called my allergist and she referred me to a GI doc. At the initial appointment, the GI says he wants to do an endoscopy. I told him I had been off gluten for a month and asked if I needed to start eating it again before the endoscopy. He said yeah, go back on it for 7-10 days. But that just doesn't seem like a adequate amount of time. Any thoughts? Any questions I should ask the GI before the endoscopy? Thanks in advance for any suggestions or commnets.

Welcome Blevois.

I think that the length of this thread may be an indication that there is no clear answer to your question. You asked ...and we are just FULL of opinions. :P You received some good answers.

With positive blood work and success (not full success) going gluten "lite", I would think that you can conclude that you have Celiac Disease, or a pretty conclusive issue with gluten. As many have mentioned, the endoscopy exam may not concentrate on the effective areas and may be inconclusive, regardless of your gluten intake. But you have two out of the three (4?) criteria for Celiac.

The endo exam can also look for the level of damage due to Celiac, as well, check for other intestinal issues that can create issues. I kinda feel it's a good thing when there has been a history of digestive issues. A base-line endo is good. :)

Do what you feel is best for you and when you're done with the endo, go as 100% as you are able and document your recovery.

I look forward to hearing from you again.
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Lisa

Gluten Free - August 15, 2004

"Not all who wander are lost" - JRR Tolkien

#24 Gemini

 
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Posted 15 October 2012 - 10:17 AM

The article's header is:
This article appeared in the Autumn 2005 edition of Celiac.coms Scott-Free Newsletter.

So, no, 7yo info shouldn't be expected to clear this up.

Did the best current celiac blood tests even exist in 2005?

We really need to use current info.


Sorry, Peter, but I needed to answer this question of Tom's!

Yes, Tom, all the up to date blood screening tests available today were there in 2005....except the DGP. That is the newest one of the AGA IgA variety. I was diagnosed in 2005 so that is why I know this. I had the full panel done and was diagnosed via blood work. 2005 was not the Dark Ages....... :lol:
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#25 mushroom

 
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Posted 15 October 2012 - 10:48 AM

I fail to see how it would be possible to design a study which would say definitively how much gluten should be consumed and for how long for a gluten challenge biopsy when these are the variables that have to be taken into consideration:

Has there been a positive blood test?

How long has subject been gluten free?

Was there a previous period of gluten free eating?

Are subject's symptoms GI only and/or neurological? (making positive less likely, anecdotally)

Number of years subject has experienced possible celiac symptoms.



You then have to put all these together and decide:

How much gluten is enough to cause damage?

How long does it take to cause damage?

Not to mention, you have to factor in the skill of the doctor performing the biopsy, the number of samples taken, the uniformity (or lack of it) of the damage, and the skill of the pathologist reading the slides.

I am no scientist, but it seems to me that we are working with far too many variables here and,as has been said before, you should do the kind of challenge that will give you the best chance of an accurate test result using the best doctor you can find. IMHO
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Neroli


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#26 IrishHeart

 
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Posted 15 October 2012 - 11:13 AM

I am no scientist, but it seems to me that we are working with far too many variables here and,as has been said before, you should do the kind of challenge that will give you the best chance of an accurate test result using the best doctor you can find. IMHO


what she said!

(If I knew how to successfully insert that cute little clapping guy emoticon in here, I would. My technical assistant is not home right now.)
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