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Using Endocytoscopy to Perform Live, Real-time Imaging of Human Duodenal Mucosal Structures in Celiac Disease

Celiac.com 02/24/2010 - Proper clinical diagnosis of celiac disease still relies on confirmation of histological evidence of villous atrophy via biopsy. Getting a good sample can sometimes be tricky. If histological sections are not optimally oriented, then diagnosis may be more difficult. As a result, doctors can sometimes fail to confirm the proper diagnosis.

A team of researchers recently set out to study the viability of confirming histological evidence of villous atrophy in real time, during upper gastrointestinal endoscopy, in live duodenal mucosa of patients with celiac disease, using endocytoscopy, a novel diagnostic technique allowing in vivo real-time visualization of mucosa under 450x magnification.

The research team included T.  Matysiak-Budnik, E.  Coron1, J.-F.  Mosnier, M.  Le Rhun1, H.  Inoue, and J.-P.  Galmiche. They are associated variously with the Institut des Maladies de l'Appareil Digestif - INSERM U913, CIC 04 et Service d'Hépato-Gastroentérologie, Hôtel Dieu, CHU de Nantes, France, the Service d'Anatomie Pathologique, E.A. Biometadys, CHU de Nantes, France, and the Digestive Disease Center, Showa University Northern Yokohama Hospital, Japan

The team studied sixteen subjects with clinically proven celiac disease, together with seven controls subjects with no celiac disease. They took endocytoscopic images from multiple areas and then made a blind comparison against standard histology.

Endocytoscopy revealed three distinct patterns of in vivo histology.

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First, in all controls and eight celiac disease patients (n = 15), endocytoscopy revealed the presence of normal-appearing, long, thin villi, lined with clearly distinguishable surface epithelial cells, considered to be normal duodenal mucosa.

Second, in four celiac disease patients, endocytoscopy revealed the presence of thick, shortened villi, reflecting partial villous atrophy.

Finally, in four celiac disease patients, endocytoscopy revealed the total absence of villi, along with the presence of enlarged crypt orifices, reflecting total villous atrophy.

The team found solid agreement between endocytoscopy and standard histology in all 16 patients with celiac disease.

From their results, they conclude that endocytoscopy permits live, real-time, noninvasive imaging and assessment of villous architecture, and looks to be a promising method for in vivo evaluation of duodenal mucosa in celiac disease.

Source:
Endoscopy: DOI: 10.1055/s-0029-12438

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Alan Adams
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said this on
02 Mar 2010 7:06:38 AM PDT
Jefferson Adams has many interesting and helpful articles. I will copy and pass this on to my doctor, as usual, who enjoys the articles too.




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Might want to look into a keto diet, I have UC on top of celiacs and keto is working great Yeah I have major nerve and brain issues with gluten, gluten ataxia with nerve issues and brain issues. Seems to cause my body to attack my brain and nerve system. My brain stumbles fogs, and starts looping, the confusion causes me to become really irritable, I call it going Mr Hyde. Like my mind will start looping constantly on thoughts and not move driving me literally mad, or it used to. Now days it is primary the numbness anger but the gut issues and sometimes random motor loss limit me motionless to the floor now days for the duration of the major anger effects. Used to be a lot more mental then painful gut. I did a mental trauma post on it on while back where I came out about all my mental issues with gluten.

^^^^^^ good info, tips and tricks^^^^^^^^^ yes, crumbs will make you sick. also, breathing flour/pancake mix, etc that is in the air because eventually, you're going to swallow some.

Hello I was diagnosed Dec 15 of last year and went totally gluten-free the next day. I actually got worse before I got better - it's a steep learning curve - but now, 4 1/2 months later I'm finally seeing improvement. Hang in there.

Called my GI doctor today to make sure he is going to look at my small intestine and do biopsy for Celiac for my EGD and he is. Thanks for the tip everyone about have to start eating gluten again. The office told me to break my gluten free diet and start eating gluten everyday until my EGD. Here's to being miserable again for a few weeks ???

I can completely relate! The horrible mental effects that I have been living with for years is the absolute worst side effect of eating gluten, HANDS DOWN. Worse than the endless tummy aches, worse than the constant diarrhea, worse than the week long migraines, worse than the daily fatigue and body pain.... I honestly though there was something seriously wrong with me and hated my life because of how I felt mentally. I always felt like I was drowning, not in control of my thoughts, trapped in some unexplained misery. My head was always so cloudy, and I was mad because I always felt so slow and stupid. I would feel so lethargic and sad and empty while at the same time be raging inside, wanting to rip out of my own skin. I was mean, terrible, would snap at the people closest to me for no good reason and just felt like I hated everyone and everything. Think of how crappy you feel when you have a terrible cold and flu - I felt that crappy, but mentally. Some days were really bad, some were mild. I always thought it was because I was getting a migraine, or because I had a migraine, or because I had just overcome a migraine, because I didn't sleep well, because....always a random reason to justify why we have all these weird unrelated symptoms before we get diagnosed. I'm happy to say that I have been gluten-free for about 2 months now and though I am not symptom free, the first thing that improved was my mood. I no longer feel foggy and miserable. For the first time in years, my head is clear, I can actually think, and I feel positive and like I am in control of what's going on in my head. I don't hate the world. I don't spend every day bawled up on the corner of the couch depressed and angry. The release of these horrible symptoms is enough to never make me want to cheat, no matter what I have to miss out on. So insane how a little minuscule amount of a stupid protein can wreck such havoc.