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endoscopy showed damage


kkgirl

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kkgirl Contributor

My endoscopy showed i had decreased folds in my duodenum. The biopsy came back and showed that my villi were fine... i have been on a gluten free diet for 6 years because i was just told i was intolerant but never had any testing before. when i eat gluten i get sick for 2 weeks. i came down with issues of other foods in march so they were trying to figure out why and wanted to know if i had celiac are not because that would explain why dairy and fructose are a problem.. both intolerant test for both were negative but the fructose test made me extremely sick but it was negative... 

 

 

Im trying to figure out why i have decreased  folds in the first place. my Gi doctor is stumped on that to why the endoscopy would show damage but the under the microscope are fine. She is going to call the dr who did my scope and then is supposed to get back to  me.. 

 

would being gluten free for 6 year make it so there was damage and then my vili are now fine but still cant be seen in the endoscope?


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GFinDC Veteran

This article suggests reduced duodenal folds are often indicative of celiac disease.

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Abstract

The loss of duodenal folds visible endoscopically has recently been reported as being a marker for celiac disease. We have investigated the sensitivity and specificity of this finding with a prospective study in 75 patients with symptoms or results of investigations compatible with celiac disease. Reported duodenal fold appearance was compared with histological findings, disaccharidase levels, and clinical diagnosis. Fifteen patients were found to have celiac disease and 11 had reduced or absent duodenal folds compared with only 2 of 60 patients who did not have celiac disease (p less than 0.0001). This finding has a sensitivity of 73%, specificity of 97%, and positive predictive value of 85%. Duodenal folds were not reported as being abnormal in seven patients with hypolactasia or two with giardiasis and did not appear to be influenced by age. A reduction in the number or height of duodenal folds as seen endoscopically in the second part of the duodenum is a specific and sensitive sign of celiac disease. Endoscopists should biopsy the duodenum for celiac disease whenever the duodenal folds appear to be reduced or absent.

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  • Open Original Shared Link [Gastrointest Endosc. 1993]

 

squirmingitch Veteran

Great sleuthing GFin DC!

GFinDC Veteran
13 hours ago, squirmingitch said:

Great sleuthing GFin DC!

Thanks Squirmy!  Actually, I have to give a little credit to my trusty sidekick Rover.  Dogpile search engine that is. :)

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    • 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.
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      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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      Have you tried Pure Encapsulations supplements? This is a brand my doctor recommends for me. I have no issues with this brand.
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