Help In Interpreting Biopsy Results - Please

[gaufu]

Hi all, I was wondering if someone can help me in interpreting my EGD biopsy results from 2 weeks ago. My doc just called me yesterday and has asked me to stay away from wheat, milk and related products. Quite honestly, I am a bit shocked. 

 

Feb 2014: Celiac Lab came back as negative in all categories but in my IBD expanded profile showed the ALCA was high with everything else in range.

 

April 2014: Biopsy reads as follows "Duodenal mucosa including bulb mucosa with brunners glands, showing elongated villous architecture. There is a mild increase in the inter epithelial T Cells (CD3) in duodenal epithelium. Gastric Metaplasia not seen in duodenal epithelium". 

 

What does this mean? Is this a cause for concern? Do i need to go on a gluten free diet? I don't have ongoing symptoms on bloating etc...

 

Looking forward to your valuable input. 

[GottaSki]

Welcome G!

 

In simple terms you have damage in your small intestine that has likely been caused by gluten and/or dairy in your diet.

 

Make sure you had all of these blood tests:

 

Total Serum IgA

tTG-IgA

tTG-IgG

EMA-IgA

DGP-IgA

DGP-IgG

 

Also helpful is blood test for nutrients as malabsorption can be an issue with the damage found during your endoscopy:

 

B6, B12, D, K, Iron, Ferritin, Copper and Zinc

CMP and CBC

 

Additionally, in this case the genetic test for genes associated with Celiac Disease could be helpful...having the genes does not mean a person will develop celiac...but genes plus small intestine damage is telling.

 

Not everyone with Celiac Disease has obvious digestive distress...there are over 300 symptoms associated with Celiac Disease.

 

If you are certain you have had all the celiac antibody tests listed above, it is indeed time to remove all gluten and dairy.  If this is Celiac Disease, you will likely get dairy products back after your intestinal damage has healed.

 

Hang in there

[gaufu]

Welcome G!

 

In simple terms you have damage in your small intestine that has likely been caused by gluten and/or dairy in your diet.

 

Make sure you had all of these blood tests:

 

Total Serum IgA

tTG-IgA

tTG-IgG

EMA-IgA

DGP-IgA

DGP-IgG

 

Also helpful is blood test for nutrients as malabsorption can be an issue with the damage found during your endoscopy:

 

B6, B12, D, K, Iron, Ferritin, Copper and Zinc

CMP and CBC

 

Additionally, in this case the genetic test for genes associated with Celiac Disease could be helpful...having the genes does not mean a person will develop celiac...but genes plus small intestine damage is telling.

 

Not everyone with Celiac Disease has obvious digestive distress...there are over 300 symptoms associated with Celiac Disease.

 

If you are certain you have had all the celiac antibody tests listed above, it is indeed time to remove all gluten and dairy.  If this is Celiac Disease, you will likely get dairy products back after your intestinal damage has healed.

 

Hang in there

Hi Lisa

Thank you for your prompt response. I have completed all the following tests...CBC,CMP, Total Serum IgA, tTG-IgA, tTG-IgG, EMA-IgA, DGP-IgA, DGP-IgG.

Further I am vitamin B-12 and D deficient so we keep testing that every 6 months. The deficiency is quite common from my country of origin, so my doc was not too concerned about that. I have had 5 EGD's from 2005 to now and none of them showed this elongated villi. Not sure how this can happen suddenly.

Anyhow, I will request my doc to do some further evaluation. My biopsy report does not say anything like March 2-3-4 or Celiac Intolerance etc...i would assume something should have been written if the diagnosis was confirmatory in nature. 

Thank you once again.

[GottaSki]

Hi Lisa

Thank you for your prompt response. I have completed all the following tests...CBC,CMP, Total Serum IgA, tTG-IgA, tTG-IgG, EMA-IgA, DGP-IgA, DGP-IgG.

Further I am vitamin B-12 and D deficient so we keep testing that every 6 months. The deficiency is quite common from my country of origin, so my doc was not too concerned about that. I have had 5 EGD's from 2005 to now and none of them showed this elongated villi. Not sure how this can happen suddenly.

Anyhow, I will request my doc to do some further evaluation. My biopsy report does not say anything like March 2-3-4 or Celiac Intolerance etc...i would assume something should have been written if the diagnosis was confirmatory in nature. 

Thank you once again.

 

If your vitamin deficiencies improve on a gluten free diet -- that is another piece of the puzzle.

 

Would be nice to have a certain answer -- but this may be one of those that removing gluten is what is needed to confirm you have an issue with gluten.  Hope that makes sense.

 

Take a read through this thread...it has wonderful info to help fast forward the learning curve involved with completely removing gluten from your diet:

 

https://www.celiac.com/forums/topic/91878-newbie-info-101/