Confused on diagnosis method

[Ram]

I've had a rash and stomach problems since I was a child and never properly diagnosed. I recently saw an allergist who confirmed that this is dermatitis herpetiformis and referred me to a gastroenterologist and a dermatologist. My blood work came out negative. The gastroenterologist is positive that is is Celiac disease and wants to do an endoscopy. The dermatologist agrees but wants to to a skin biopsy. Is it necessary to do both since I read that the skin biopsy should be enough? My gastro says the endoscopy is important because by blood work is negative and it has to be positive to confirm celiac along with a skin biopsy. I am honestly worried with covid19 and the invasive nature of the endoscopy. "Image of my heavily scratched rash attached." Thanks!

[trents]

I've had several endoscopies performed over the years and they are a quick and easy procedure. Doesn't require bowel prep, just no food after midnight the day before. Out patient procedure, conscious or light sedation and very minimal risk. Not painful or unpleasant at all. I understand your concern about COVID but personally, I think the peace of mind from the information it would provide would be worth the risk. And with the sanitation the procedure room staff take, you are probably more protected from COVID in the medical setting than on the outside. And the And if you go gluten-free before having an endoscopy you would have to start eating gluten again if you ever did decide to have it done.

Edited November 5, 2020 by trents

[Scott Adams]

Perhaps get the skin biopsy first and see what the results are, then consider doing the endoscope if there are still questions? Both tests are not a big deal.