follow up endoscopy after 1 year gluten-free

[PersianCeliac]

Hello,

Both my aunt and mom were diagnosed with celiac. My aunt had severe symptoms and biopsy showed Marsh 3C.

mom no symptoms and biopsy showed Marsh 3B. Mom’s endoscopy and biopsy after almost 2 years gluten free was normal.

 

my aunt  had her follow-up endoscopy and biopsy 1 year after being gluten free. her biopsy was completely Normal. Normal villi and no atrophy (from Marsh 3C ! Proud niece !) . However, her endoscopy showed some signs of celiac with the duodenum appearing as scalloped with reduced duodenal folds.

i am confused and hoping someone can help, how come her histology is normal now with normal Villi, but her duodenum still looks abnormal ?

shouldn’t the appearance of the duodenum normalize before the histology ?

As both mom and aunt didn’t know much about celiac, I was their advocate so to say and helped them through the process, testing and follow-up. I am just worried about aunt’s endoscopy though despite normal histology. 

[cyclinglady]

Hi!  
 

Congratulations!  I am so happy for your mother and Aunt.  Not sure about your question though.  I am just guessing, but maybe your Aunt has permanent damage (structural changes).  I think the important thing is the intact villi.   I had a 3B, and no structural changes at all, at least that were noted.  My GI just said everything looked fine.  Nothing said on the endoscopy report.    Just the biopsies revealed the villi damage when I was diagnosed. My repeat biopsies showed complete healing, but that was evident during the endoscopy as well.    My new GI had a scope with tremendous magnification.  You could see the villi!  I even got a photo.  

Maybe the scalloping is due to another illness?  Maybe she needs a bit more time?

I did find this article showing healing after five months, but it did not say how old the patient was.  Age might come into play.  I sure do not heal fast anymore!  
 

https://www.endoscopy-campus.com/en/bildergalerie/endoskopische-befunde-bei-zoeliakie-einheimischer-sprue/

 

I think if your Aunt’s Gastroenterologist is happy  and she is feeling well, then I would not worry.  

Edited August 1, 2020 by cyclinglady

[knitty kitty]

Persian Celiac and Cycling Lady,

I found this article about a very small sample of people that seems relevant. 

https://pubmed.ncbi.nlm.nih.gov/10840307/

Perhaps further investigation is warranted. 

Although more time for healing may be what is needed, like Cycling Lady suggested.