Confusing test results -positive blood, negative biopsy

[AZLisa]

Hi all,  I have read all the posts about this topic and am still confused.  I was tested for celiac disease because I was iron deficient and also my B vitamins, D and omega fatty acids were very low.  I also am having issues with a severe chronic cough.(.nothing has helped it), acid reflux, severe fatigue,  bloating and burning stomach pain. 

One antibody test came back positive ..

Gliadin (Deamidated) Peptide Antibody, IgA*
Gliadin (Deamidated) Antibody IgA 34.0 H * ≤14.9 U/mL
Gliadin (Deamidated) Antibody IgA Positive 

The other tests..total IgA, and Tissue Transglutaminase Antibody IgA were negative,

My GI doctor felt for sure I had Celiac and we scheduled a biopsy.  Yes, I ate gluten before the blood tests and biopsies.   So the biopsies for the small intestine were negative.  He biopsied four areas.  The stomach biopsy showed reactive or chemical gastritis.   I am not sure what causes this chemical gastritis since I do not drink alcohol or take NSAIDs.

The GI doctor was very surprised at the biopsy results because he felt from the blood tests there was a 95% chance I have celiac.  I have one of the genes and a first cousin with it.  He told me to still go on a gluten free diet to see if it helped.

So, I am confused.  Do I have it or not? The biggest problem for me is this severe chronic cough that is affecting every aspect of my life.  Nothing has helped it.. I have seen numerous doctors.  I am on 80 mg of omeprazole trying to control acid reflux if it is the cause.  

I am on a gluten free diet now for two weeks.  So far only the bloating is much improved… and maybe my energy a little. 

So is the biopsy still the “gold standard” for diagnosis? I read in Europe they are diagnosing based on blood tests alone and that the biopsy cam be negative. Then I read some people here say NO your biopsy must be positive…

 

Any input would be appreciated! Thank you!

 

Lisa

 

 

 

 

[Wheatwacked]

Welcome AZLisa, 

Omeprazole-induced intractable cough Conclusions: Chronic, persistent cough may occur as an adverse effect of omeprazole therapy. Clinicians must be aware of this adverse effect to avoid useless and costly tests.

While the biopsy is the gold standard to diagnose Celiac Disease, it is not the gold standard to rule out Celiac Disease. Especially since you show improvement on the gluten free diet. Many others have had the same conundrum Am I or not. Go with your doctor and your gut. It does take time to heal and replete your low vitamins. Your body needs them to heal so the faster you bring them to optimum the quicker you heal. With so little damage you are ahead of the healing curve.

The acic reflux will improve on gluten free and proton pump inhibitors lower stomach acid causing its own issues with malnutrition, suseptibility to Small intestinal bacterial overgrowth (SIBO) Patients with SIBO may also suffer from unintentional weight loss, nutritional deficiencies, and osteoporosis.

Be careful when you cough. My doctor put me on Lisinopril for blood pressure and that persistant cough caused an inquinal hernia. Didn't do a thing for BP.

 

 

Edited April 3, 2023 by Wheatwacked

[Wheatwacked]

For stomach upset or other pain I always go to Alka Seltzer. Bicarbonate and aspirin. Aspirin is easier on the stomach and liver than NSaids. Oddly enough aspirin is  acetylsalicylic acid  Salicylic Acid is Vitamin B11 (PHGA-salicylic-acid). And so is more natural to our bodies than NSaid Cox inhibitors. Aspirin was derived from willow bark. Native Americans made tea from it for fever.  

Aspirin: Turn-of-the-Century Miracle Drug

[AZLisa]

Thank you very much for your input! The cough is not from omeprazole because I had it way before I even started it.  It was tried in order to help the cough.

the cough is very frustrating. I am not on any medicine that would cause it. I have been to every specialist imaginable. I think my GI doctor started to think it was from gluten but we will see.

 

 

Lisa

[Scott Adams]

At this point you may have non-celiac gluten sensitivity, which some doctors believe to be a pre-celiac state, although there is a lot of debate about this among the medical community. In any case, if you have a single positive test for blood test celiac disease, and some or all of your symptoms go away when you go gluten-free, then your doctor is likely correct, and you should just go gluten-free.

[AZLisa]

Thank you Scott.  My doctor sad that since that was a positive autoantibody test, it shows autoimmune illness. Non celiac gluten sensitivity is not autoimmune I thought .   But I didn’t know that some consider it a pre-celiac state.   I wish it had been more clear cut. I just came from my primary care doctor who said she has had several patients with positive bloodwork and a negative biopsy.   

Thanks for your input.

[Scott Adams]

I would side with your doctor at this point, and I agree that those without autoimmune issues to gluten should not have any positive antibody tests for it, and possibly even not have elevated, or barely below positive test results. It's strange to me that in the past ten years they have created a new "weak positive" zone for blood test results, but not a "weak negative" zone.