Interpreting Biopsy Results

[Wendy24]

I was having major issues with diarrhea and other issues until I stopped eating gluten about 9 months ago.  Because of my symptoms the doctor ordered a endoscopy, but I as I said I was not eating gluten at the time of the test.   The test apparently rules out Celiac disease, but I don't understand what the Specimen C: means - can anyone explain it to me?

 

 

Specimen A:   Duodenum, mucosal biopsies: within normal limits

 

Specimen B:   Stomach, mucosal biopsies: mild nonspecific chronic gastritis with associated reactive changes, negative for inflammation      negative for H. Pylori organisms by H and E strain

 

Specimen C:  Colon, random mucosal biopsies:  minimally increased intraepithelial lymphocytes, please see microscopic description  (   the biopsy show regular crypt placement without significant crypt architectural distortion.  Scattered lymphoid aggregates are seen in the lamina propria.  Occasional foci of minimally increased intraepithelial lymphocytes are identified, numbering approximately 12-15 lymphocytes per 100 enterocytes.  The findings are somewhat nonspecific and may be seen in the setting of medication effect, inflammatory bowel disease, lymphocytic colitis, or other autoimmune diseases.  Clinical correlations recommended.   

 

Frustrated!!! The doctor gave me a low-fodmap diet for IBS which I no longer have an issue for and currenlty eat many of the healthy items on the eliminate foods containing fodmaps.     

[LauraTX]

Hi Wendy and Welcome to the forum!  I moved your post to a new topic of its own so people could answer you and the other person separately to avoid confusion.

 

The specimen C is labeled as being from your colon, which is not where the brunt of Celiac damage is, so I am not sure about those findings.  Hopefully one of our more well-read members will chime in once the morning hits.  Specimen A is where the main Celiac findings would be, but as you said, if you were not actively consuming gluten they may be a false negative and does not definitively rule out celiac disease.  It does look like they took more than one duodenal biopsy, but either way it won't matter if you were not consuming gluten.

 

If you are getting inconclusive results with the low FODMAP diet, you may consider speaking to your GI doctor about doing a proper gluten eating challenge and re-testing in a proper manner.