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Still Showing Damage


Katie876

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Katie876 Newbie

I was diagnosed in the beginning of Dec with celiac. I just got my endoscopy yesterday, gastrointologist was expecting not to find any damage but I still do. Is this normal and how long could it take to heal? I'm still waiting for the biopsy results. I'm confused what the biopsy results will tell us? All 4 of the lab tests came back positive and there is obviously still damage. Why did they have to do a biopsy too? Thanks


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kareng Grand Master

I was diagnosed in the beginning of Dec with celiac. I just got my endoscopy yesterday, gastrointologist was expecting not to find any damage but I still do. Is this normal and how long could it take to heal? I'm still waiting for the biopsy results. I'm confused what the biopsy results will tell us? All 4 of the lab tests came back positive and there is obviously still damage. Why did they have to do a biopsy too? Thanks

 

 

I don't think I am understanding?  Why would the GI do an endo a month after the first one?  It usually takes longer than a month of gluten free to heal the damage.  Heck, it takes at least a month to get the gluten-free diet figured out and perfected.  

 

 

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How long does it take for the villi to heal themselves?

The amount of time it takes the villi to heal themselves is highly variable. It can take from 1-2 weeks or several years for most. Unfortunately, complete healing never occurs for some.

 
 
How often should follow-up testing occur?

New celiacs should receive follow-up testing twice in the first year after their diagnosis. The first appointment should occur 3-6 months after the diagnosis, and the second should occur after 1 year on a gluten-free diet. After that, a celiac should receive follow-up testing on a yearly basis. We recommend checking both tTG and DGP (Deamidated gliadin peptides) at each screening.

Katie876 Newbie

This was my 1st endoscopy yesterday. I got my blood results back in the beginning of December. My dr wanted me off gluten that day. The 1st I could get in to do the endoscopy was yesterday. They figured bc I've been gluten-free for 2 months they shouldn't have seen as much damage as there was. I'm new to this so I'm still learning:)

cristiana Veteran

Hi Katie

 

I think Kareng is right - it varies so much.  I wouldn't be too anxious about it.  I have never had a second follow up endoscopy although I'd quite like one just because I'd like to see how much I have improved with all my hard work (minus a few accidental glutenings) after all these months.

 

I was really in a bad way at diagnosis and really only recently have I decided  my gut must be better as I am putting on weight, suddenly, really easily. :unsure:   So it has been really a two years for me.

 

We are all still learning....

cristiana Veteran

Oh .... forgot to add this.

 

This explains the biopsy bit.  This tells the experts how much the villi have been damaged.  

 

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(PS excuse English spelling of celiac!  I still don't know why we spell it differently!)

GFinDC Veteran

That's pretty much the standard process, doing blood antibody tests first and then an endoscopy.  Usually the person is supposed to keep eating gluten until the endoscopy is done though.

  • 2 months later...
Posterboy Mentor

Still Showing Damage,

 

Biopsy are the old school way to test for gluten free dietary compliance.  The villi however take most people 1 year approx to heal the majority of the way.  2 years are needed for most people(if no cheating occurs hence the 2nd biopsy) for complete remission.  If the Celiac is not in remission in 2 years it is consider refractory (non-healing) type.

 

Blood serology in the short term 1-6 months are much easier and possibly more accurate with gluten antibodies going down dramaticlly with in one month.  It sounds like a blood exam was called for here.  At 6 months if you are adhering to strict gluten-free diet most all the remaingin antibodies for gluten go away.

 

See above how villi healing takes twice to four times as long to heal to pass biopsy (gold standard) for Celiac Disease.

 

But if there is no gluten and/or ie antibodies the body will begin to heal as soon as a month as evidenced by the dramatic drop in blood (serology) antibodies indicate by a 2nd follow up blood panel.

 

Posterboy,


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    • par18
      Thanks for the reply. 
    • Scott Adams
      What you’re describing is actually very common, and unfortunately the timing of the biopsy likely explains the confusion. Yes, it is absolutely possible for the small intestine to heal enough in three months on a strict gluten-free diet to produce a normal or near-normal biopsy, especially when damage was mild to begin with. In contrast, celiac antibodies can stay elevated for many months or even years after gluten removal, so persistently high antibody levels alongside the celiac genes and clear nutrient deficiencies strongly point to celiac disease, even if you don’t feel symptoms. Many people with celiac are asymptomatic but still develop iron and vitamin deficiencies and silent intestinal damage. The lack of immediate symptoms makes it harder emotionally, but it doesn’t mean gluten isn’t harming you. Most specialists would consider this a case of celiac disease with a false-negative biopsy due to early healing rather than “something else,” and staying consistently gluten-free is what protects you long-term—even when your body doesn’t protest right away.
    • Scott Adams
      Yes, I meant if you had celiac disease but went gluten-free before screening, your results would end up false-negative. As @trents mentioned, this can also happen when a total IGA test isn't done.
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