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Having Endo/biopsy Next Week

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HI, I recently got the blood test drawn to test for celiac and am waiting for the results to come back. Next week I'll have an endo done. 


I have questions though, about it because I've read different things online. I have been on a somewhat low carb diet for a year or so. I'm not strictly gluten free, but honestly don't eat a lot of gluten except for weekends. Maybe a cheat once in a while during the week. So I guess you could say I eat a "low gluten diet". Now after researching about how celiac disease is diagnosed, I'm concerned I won't have enough gluten in my system for it to show up in the blood work or biopsy. Is that correct, or will it be fine? I keep seeing you have to eat 2-4 pieces of bread (or equivalent) for several weeks prior to a biopsy? 

Anyone know if that's true? My dr didn't' ask about my diet, or mention that I would have had to be on a gluten diet prior to it, I didn't realize this until reading later. 

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The most common recommendation is 1-2 slices of bread per day (or equivalent - noodles, muffin, cereal).  2-4 slices is on the high end and is a good idea if doing a short gluten challenge (like 4-6 weeks).  Some say 1/2 a slice is enough, and that is often for the longer gluten challenges (closer to three months).  


Now those times are for the blood tests.  The biopsy usually requires a gluten challenge of 2-4 weeks of about 1-2 slices of bread per day.  If you are unsure if you have had enough gluten, start eating more and try to get it to 2 slices of bread per day (or a big bowl of noodles or a few cookies or muffins).


If your blood tests are negative, you may want to try a real gluten challenge for another 6 weeks or so and up your gluten intake and then retest.  The problem is that none of the tests are perfect.  The biopsy can miss up to 1 in 5 celiacs, and the blood tests can miss up to 1 in 4 celicas.  See page 12 of this report (sensitivity) for more data: http://www.worldgastroenterology.org/assets/export/userfiles/2012_Celiac%20Disease_long_FINAL.pdf


Good luck with the tests.  :)

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