Celiac or Gluten Intolerance?

[Tyee]

Hi- 

After experiencing very light symptoms, I went in to my GI doc who assumed IBS but tested me for celiac. 

Blood tests came back positive for celiac  and I had endoscopy yesterday. I am not yet Gluten Free. The doctor mentioned that if the Endoscopy biopsy comes back negative, that it could just be a “gluten allergy”…

Given that I would be in the VERY early stages of celiac disease (symptoms are bloating and diarrhea for ~6-12 months), I don’t feel as if the damage would be substantial enough to flag during the endoscopy. 

Is it possible for Celiac disease to go undiagnosed during its early stages?
Or is it possible for a gluten allergy to produce the same antibodies? 

Antibodies:

Gliadin (DPG) IgG: 65 

tTg IgA: 57

tGg IgG: 28 

Thanks in advance for any insight!!  

[Tyee]

37 minutes ago, Tyee said:

Hi- 

After experiencing very light symptoms, I went in to my GI doc who assumed IBS but tested me for celiac. 

Blood tests came back positive for celiac  and I had endoscopy yesterday. I am not yet Gluten Free. The doctor mentioned that if the Endoscopy biopsy comes back negative, that it could just be a “gluten allergy”…

Given that I would be in the VERY early stages of celiac disease (symptoms are bloating and diarrhea for ~6-12 months), I don’t feel as if the damage would be substantial enough to flag during the endoscopy. 

Is it possible for Celiac disease to go undiagnosed during its early stages?
Or is it possible for a gluten allergy to produce the same antibodies? 

Antibodies:

Gliadin (DPG) IgG: 65 

tTg IgA: 57

tGg IgG: 28 

Thanks in advance for any insight!!  

(Results are in U/mL & the standard range is 0-15 for each blood test)

[trents]

Welcome to the forum, Tyee!

Please post back with reference ranges for your antibody test results, that is, what constitutes negative vs. positive. Reference ranges used by labs vary from place to place. There is not yet an industry standard.

A "gluten allergy" would not produce positive celiac antibody values. Celiac disease is an autoimmune disorder, not an allergy. It engages an entirely different immune system pathway.

It is not always possible to gauge whether or not someone is in the early stages of celiac disease based on symptoms. Many celiacs have no symptoms for years until the damage to the villi  of the small bowel gets terrifically bad. We call them "silent" celiacs. Believe it or not, it can take as little as two weeks of regular gluten exposure to produce detectable damage to the small bowel villi. The actual damage is visible vial biopsy under a microscope before antibodies are detectable. 

[Tyee]

35 minutes ago, trents said:

Welcome to the forum, Tyee!

Please post back with reference ranges for your antibody test results, that is, what constitutes negative vs. positive. Reference ranges used by labs vary from place to place. There is not yet an industry standard.

A "gluten allergy" would not produce positive celiac antibody values. Celiac disease is an autoimmune disorder, not an allergy. It engages an entirely different immune system pathway.

It is not always possible to gauge whether or not someone is in the early stages of celiac disease based on symptoms. Many celiacs have no symptoms for years until the damage to the villi  of the small bowel gets terrifically bad. We call them "silent" celiacs. Believe it or not, it can take as little as two weeks of regular gluten exposure to produce detectable damage to the small bowel villi. The actual damage is visible vial biopsy under a microscope before antibodies are detectable. 

Thanks for the welcome and the information Trents! It seems I may qualify under “silent celiac” as I have a presence of what I would consider ‘minimal’ symptoms. 
 

The blood results I have posted are in U/mL & the standard range is listed as 0-15U/mL for each of these tests).

I am still waiting for my biopsy results but given the nurse informed me that “all looked perfect”, i am worried that I will not have a confirmed diagnosis.  

I also worry that my doctor may not be as competent as I would hope given I had asked her “besides celiac, could anything else yield these results?” And she mentioned that I could just be “sensitive to gluten” (I.e. gluten allergy). 
 

From my research, it may simply be that we have caught the disease early enough to not have much damage present… but then again, I believe the diagnosis of celiac is confirmed through damage done with the presence of these antibodies. 
 

Possibly a “future Celiac”…?

[trents]

NCGS (Non Celiac Gluten Sensitivity) is about 10x more common than celiac disease but it does not cause inflammation in the small bowel and should not produce elevated tTG-IGA or elevated tgg-igg. There is no test for NCGS. Celiac disease must first be ruled out. Celiac disease and NCGS share many of the same symptoms, however. NCGS is not an allergy. Although it is possible to have a true allergy to gluten (as it is to any protein) I wish medical professionals would quit using the term "allergy" to refer to NCGS. I only hope they are doing so with awareness and are just trying to communicate in common parlance. 

[cristiana]

4 hours ago, Tyee said:

I am still waiting for my biopsy results but given the nurse informed me that “all looked perfect”, i am worried that I will not have a confirmed diagnosis.

Hello there Tyee

Welcome to the forum.

When I read this it reminded me of the letter I got from my consultant when I was awaiting my biopsy results.  He wrote the endoscopy was normal.  By that I think he meant he couldn't see any stomach ulcers, bleeding etc.  The thing is, it isn't always possible to see coeliac villi damage with the naked eye.    When my biopsy results came back, sure enough, I had Marsh III damage, which is a scale they use to gauge damage.  

Hopefully your biopsy results will give you clarification.

Cristiana

[Scott Adams]

If the cut off for each test is >15 is positive, and you had these results:

• Gliadin (DPG) IgG: 65 
• tTg IgA: 57
• tGg IgG: 28 

It would seem that you are clearly in the celiac disease category. It's possible they caught this early, but there is no easy way to know this.

Within this article is a section on diagnosing celiac disease using blood tests only, and using tTg results doctors in the UK and other countries are now diagnosing celiac disease when those levels are 5-10 the cut off mark for celiac disease, and your tTg IgA is 3.8 times this level. DPG isn't being used in this way yet, but your level is 4.33 times the cut off level. The fact that all 3 tests are strongly positive means that you have a very high likelihood of having celiac disease, not matter what your endoscopy results show.

 

[Tyee]

1 hour ago, Scott Adams said:

If the cut off for each test is >15 is positive, and you had these results:

• Gliadin (DPG) IgG: 65 
• tTg IgA: 57
• tGg IgG: 28 

It would seem that you are clearly in the celiac disease category. It's possible they caught this early, but there is no easy way to know this.

Within this article is a section on diagnosing celiac disease using blood tests only, and using tTg results doctors in the UK and other countries are now diagnosing celiac disease when those levels are 5-10 the cut off mark for celiac disease, and your tTg IgA is 3.8 times this level. DPG isn't being used in this way yet, but your level is 4.33 times the cut off level. The fact that all 3 tests are strongly positive means that you have a very high likelihood of having celiac disease, not matter what your endoscopy results show.

 

Hi Scott - thank you very much for breaking this down for me and providing the information and the link. I’m still awaiting biopsy results but this has helped me to better understand my results and hopefully manage this before it may worsen. 
I greatly appreciate you taking the time to comment. 

14 hours ago, cristiana said:

Hello there Tyee

Welcome to the forum.

When I read this it reminded me of the letter I got from my consultant when I was awaiting my biopsy results.  He wrote the endoscopy was normal.  By that I think he meant he couldn't see any stomach ulcers, bleeding etc.  The thing is, it isn't always possible to see coeliac villi damage with the naked eye.    When my biopsy results came back, sure enough, I had Marsh III damage, which is a scale they use to gauge damage.  

Hopefully your biopsy results will give you clarification.

Cristiana

Thank you Cristina. I am keeping hope that my biopsy will provide me answers. I appreciate you taking the time better explain the endoscopy/biopsy process for me.