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jacflash

Member Since 14 Feb 2009
Offline Last Active Jan 07 2010 06:32 AM
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Topics I've Started

Why Is Endoscopy Still "the Gold Standard"?

19 February 2009 - 08:05 AM

I am new to the world of Celiacdom and the whole online culture of the community. Please forgive me if this is a silly or offensive question; it is meant sincerely.

In light of the very high accuracy of the tTG test, and in light of studies showing that a tTG over 30 is 100% indicative of celiac disease except under clearly-understood circumstances, why do people still insist on a biopsy? In 3-4 days of scanning online forums I've repeatedly seen biopsies referred to as "The Gold Standard" (caps and all) and even a couple of folks who refer to themselves as "Gold Star Celiac", like it's a status symbol.

Now, if I were the executive director of The National Association for the Financial Enrichment of Gastroenterologists, I'd love this sort of mindset-establishing branding. But as someone who has probably had undiagnosed celiac disease for decades, who got a 59 on the tTG, who is probably facing a 'scope in a few weeks, and who is -- and this is the real reason I ask -- REALLY reluctant to inflict scopes on his 9-yr-old and 6-yr-old sons who probably also have it, what's the point? What useful, relevant info does the biopsy consistently deliver that a high-positive tTG plus several months on the diet wouldn't? Why should I do this to my kids?