Only Endoscopy?

[ronswanson]

I had an endoscopy last week because I am preparing for weight loss surgery.  The doctor called me two days ago and told me that I have inflammation and atrophy diagnostic of Celiac.  I have had digestive and gastric issues for many many years but I had always had it in my head that it was just a part of being overweight and I never really questioned it since the symptoms are not that severe.

 

My question is, can you be diagnosed WITHOUT the IgA testing?  I do have an appointment on Monday for the blood testing but I was just curious.  Can that test be negative with a positive endoscopy?  

 

In everything I have read so far, it seems that the IgA testing is always done first, which leads to endoscopy.  

 

Thanks in advance.

[psawyer]

Welcome to the community.

 

Yes, you can be diagnosed based on endoscopy and biopsy alone. I was. The blood tests are considered screening tools to decide whether an endoscopy is indicated.

 

A false negative on the IgA tests can happen for several reasons.

[CajunChic]

Yes, it is possible to be seronegative (negative blood work) and have a positive biopsy. There are different combinations of ways people have been diagnosed. Many celiacs are IgA deficient, so if thats the case all IgA tests are invalid and you'll have to be tested on IgG tests. Whatever the tests show, you're probably definitely a celiac based on your biopsy.

Check the newbie thread for great advice on going gluten free, it helped me so much!

Good luck on your gluten free journey and welcome!

[ronswanson]

Thank you both for your reply.  This news has boggled my mind.  I am very much looking forward to this journey and I really hope that it has been the cause of so many symptoms that will now go away.  Fingers crossed.

 

Thank you all for being here and creating this informative place!

[JodyM75]

I went in for a routine endoscopy the beginning of April, I've had a hiatal hernia for 20+ years.  I asked my doc to do a celiac test to rule it out.  I also have gastroparesis (delayed stomach emptying) and that is one of the symptoms of celiac.  I figured we would be able to rule it out as a problem

 

Wrong-o, the test came back positive for celiac.  I had the blood for the celiac panel taken just this past Friday and I'm still waiting on results.  So, yeah, diagnosis can happen opposite of the usual blood tests first/biopsy later method....

[kareng]

I thought I saw somewhere that people with Celiac can only have certain weight loss procedures. I'm looking to see if I find it. I did find this :

Open Original Shared Link

"METHODS:

We report 5 morbidly obese patients that were diagnosed of celiac disease during preoperative work-up for bariatric surgery. Diagnosis was suspected during routine upper endoscopy, and confirmed by histology and positive celiac disease-specific serology."

[ronswanson]

Thanks for that link. That is interesting. I did speak with my surgeon yesterday and he has officially cleared me for sleeve gastrectomy surgery. I am going to do more research.

[thepeach80]

Being a new diagnosis, I'd wait on surgery. See what going gluten free does for you. Having gastric surgery is a big change and requires lots of diet changes and often B12 supplements. Gluten free is a big enough change for most people to handle without adding more to it. I was like you, we did things backwards. Scope, which showed damaged consistent with Celiac, and then blood work. I was told my blood work was negative but some would call it a weak positive and I feel 100x better off gluten so that is how I will stay. It's been a year now.

[ronswanson]

Being a new diagnosis, I'd wait on surgery. See what going gluten free does for you. Having gastric surgery is a big change and requires lots of diet changes and often B12 supplements. Gluten free is a big enough change for most people to handle without adding more to it. I was like you, we did things backwards. Scope, which showed damaged consistent with Celiac, and then blood work. I was told my blood work was negative but some would call it a weak positive and I feel 100x better off gluten so that is how I will stay. It's been a year now.

 

I get your POV but I can't even imagine delaying surgery now. It has been over a year of mentally and physically preparing myself for this.  At this point, I feel prepared to take on almost anything.

[kareng]

I get your POV but I can't even imagine delaying surgery now. It has been over a year of mentally and physically preparing myself for this.  At this point, I feel prepared to take on almost anything.

I looked up a few things and it seems the sleeve is recommended for " sprue ". That is an old name for Celiac Sprue. Google autoimmune and bariatric and you should find things like that. The good thing about the sleeve is you can adjust/ remove it. Is that correct? To me it seems less drastic than a bypass. I have a few friends with that, and I am not convinced that was good for their health.

[ronswanson]

I looked up a few things and it seems the sleeve is recommended for " sprue ". That is an old name for Celiac Sprue. Google autoimmune and bariatric and you should find things like that. The good thing about the sleeve is you can adjust/ remove it. Is that correct? To me it seems less drastic than a bypass. I have a few friends with that, and I am not convinced that was good for their health.

You are thinking of the band surgery, which applies a band around the top of the stomach.  The sleeve is not reversible but it is also not a malaabsorptive (sp?) procedure like the bypass procedures are.  Basically, it cuts your stomach down to almost an 1/4 of its size so you still absorb all of what you eat but can only eat much smaller portions. I am not a sweets person so the gluten I need to eliminate consists more of savory gravy's in various foods along with the breads and pastas.  I have already been mentally preparing myself for the lose of those anyway so I really do feel prepared either way.  I will still be having an in-depth conversation with the surgeon and my gastro about it.  I an appointment on Monday to meet with both.

[ronswanson]

Hi all.  So I finally got my blood results back and all were normal.  They ran Endomysial IgG, TTG IgG and IgA and IgA levels.  My IgA level was on the low side of normal but everything else was well within normal range.  When I went in for the blood work, the gastro told me that I had what they call scalloping of the intestines with some atrophy commonly seen in Celiac.  I haven't spoken to him yet (saw my results online) but I am still bothered by negative results.  I plan to change my diet anyway and eliminate gluten from it because I think that could only help my intestines at this point.  However, there seems to disagreement between doctor opinion in scientific articles as to whether a negative serology with positive endoscopy is truly diagnostic of Celiac.  I'm confused and do wonder if something else may be going on.  Hopefully nothing even more serious.