what treatment gastroenterologist suggest to celiac diagnosed patients?

[Guest]

Hello everybody. I posted a month ago to get help about blood tests. I have results of celiac panel test now,

tTG IgA                   15.22 U/ml                     Negative : less than 12 U/ml            Equivocal: 12 to 18 U/ml         Positive: greater than 18 U/ml

Serum IgA               3.23 g/l                           (0.4 to 3.5)

endomysial IgA      3.1 U/ml                        Negative : less than 10 U/ml            Equivocal: 10 to 15 U/ml         Positive: greater than 15 U/ml

serum IgG              17.56 g/L                       (6.5 to 16)

tTG IgG                   36.52 U/ml                   Negative : less than 12 U/ml            Equivocal: 12 to 18 U/ml         Positive: greater than 18 U/ml

DGP IgG                 46.64 AU/ml                 Negative : less than 15 AU/ml            Equivocal: 15 to 30 AU/ml         Positive: greater than 30 AU/ml

DGP IgA                 45.75 AU/ml                 Negative : less than 15 U/ml            Equivocal: 15 to 30 U/ml         Positive: greater than 30 U/ml

now do I need biopsy for further treatment because 5 results out of 7 are positive so it is sure that I have celiac. What treatment doctor would suggest for this disease or I dont need to go to doctor and should start gluten free food from tomorrow?

[Gemini]

Hi Saghar.......well, your testing shows you are reacting to the gluten in your diet and that you may have intestinal damage also.  Some doctors may diagnose you on these alone but many will not.  It sure looks like you have Celiac but is it possible for you to have the biopsy?  Would you be able to accept these results as true and stay on a strict gluten free diet for the rest of your life, without doubts? If not, I would advise the biopsy.  Just keep in mind that the biopsy is not 100% either.  If they miss the spots that are affected, they will give a negative result, even if you have Celiac. It is just so tricky to diagnose Celiac, unfortunately.

The treatment would be the exact same in all cases...the gluten free diet. That is the only sure fire way to get healthy with Celiac Disease.

[squirmingitch]

If your doctor will diagnose you based upon the blood work alone then it's your choice to get an endoscopy or not but if the doctor insists on an endoscopy to diagnose you then you need to consider what Gemini said about will you be able to stick firmly to a gluten free diet. The other thing is, if you have kids or not. If you don't have a written diagnosis then it will be harder to get your kids tested. All first degree relatives (parents, siblings, children) of celiacs should be tested every 2 or 3 years because celiac can present at any age. 

[ravenwoodglass]

You could talk to your doctor and see if they will diagnose based on your blood test results and their decrease after 6 months or so gluten free. Some doctors will but many will want you to have the biopsy with a GI. If you do decide to endo then you could ask to be put on a 'cancellation list' if you are able to get in on short notice. That could cut down on the amount of time you have to wait. If you want to have an endo then do be sure to keep eating gluten until that is done. You don't have to eat a lot. A couple slices of bread worth of gluten is enough.  Once you are done with any celiac testing you do need to go strictly gluten free. There really is no doubt you need to be with those test results.