Endoscopy

[Mama2alot]

A few weeks ago, I went to the gastroenterologist because  I am coughing every night when I laid down and experiencing a lot of heartburn. The doctor put me on Prilosec (which seems to be helping) and scheduled me for an endoscopy. I had the endoscopy last Friday. I was told I have a lot of dilated lacteals and he is concerned I have celiac. This was the first mention of celiac. He biopsied them. I’m still waiting for the results, as the doctor was out of the office this week. He said he would call me when he gets the results and he would talk to me about what the next steps are.
 

Of course, as soon as I got home I started researching celiac. I haven’t found anything about dilated lacteals in the duodenum. Can a doctor “see” celiac damage during the endoscopy? I was still pretty out of it when he talked to me after the endoscopy, so I didn’t think to ask questions. Does this sound like it could be celiac?

[cristiana]

Hi Mama2alot and welcome to the forum!

I cannot say that I have ever seen that term before.  However, what I can tell you is that when I was diagnosed, here in Britain, at around the same time as two other friends, one of them told me her gastroenterologist actually saw the damaged villi during her endoscopy and told her before the biopsies were sent off that she had coeliac disease.  I'm hoping others will be able to chime in if they have had this happen to them. 

I also have the nighttime coughing by the way - I have it at the moment, so my sympathies.   I tend to get it when I have had a bout of gastritis, often caused by gluten exposure.  Or if I've been taking aspirin, or certain other medication.  It's woken me up two nights running now.   I find it really helps to take a short course of omeprazole, eat my last meal 3 hours before bedtime, avoid spicy and fatty foods and have a teaspoon of Gaviscon when it is really playing up last thing at night.  I've also bought a wedge shaped pillow that I use which also helps.  Some people prop the pillow end of their bed up on bricks - same sort of effect - to help gravity keep the stomach contents where they should be!

Do come back to us if you need any more help, I hope your meeting with the doctor is helpful next week.

Edited July 9, 2021 by cristiana

[trents]

An experienced gastroenterologist can spot damaged small intestine villi if the damage is dramatic enough and if the scope has high resolution. Celiac disease creates inflammation in the small bowel when gluten is ingested. This inflammation damages the villi that line the small bowel. We refer to this as "villi blunting." The villous lining is the organ of nutrient absorption. When the villi are blunted the surface area for nutrient absorption is reduced. This is why celiacs often suffer from medical problems associated with vitamin and mineral deficiencies.

Another associated phenomenon with the celiac reaction to gluten is "leaky gut." The spaces between the cells that line the gut are enlarged, allowing larger than normal protein fractions from our food to enter the blood stream. These may be detected as invaders and result in allergies/intolerances to other foods that do not contain gluten.