How many weeks of gluten intake needed for accurate endoscopy?

[FelicityM]

Hi there, my 19 yr old daughter is in the process of working out whether she has celiac disease or not.  She's had the gene test, which came back positive and is now deciding whether go with the blood test and/or the endoscopy.  My question though relates to how long she needs to consume gluten for each of these tests?  The dr said 6 weeks of gluten for the blood test, but we're not sure if that's the same for the endoscopy. She has been off gluten for around 3 weeks now (except for a couple of small contaminations) and is dreading the idea of going back on it.  Obviously we don't want to under do it and get a false negative result, but at the same time 6 weeks of massive fatigue, brain fog, body pain etc is a lot!  We're hoping the endoscopy might require a shorter amount of time consuming gluten.  Could anyone confirm this please?

Also, upon reading some of the forum messages I can see that people seem to get regular blood tests to check their levels.  In that case, I suppose it would make sense to get both tests done, so she has the actual diagnosis (if positive) and a baseline reading of her bloods, so we can see if the gluten-free diet is definitely working.  Is this the general consensus?  Thanks so much in advance.

[trents]

More recent guidelines for the pretest "gluten challenge" specify at least 10g of gluten daily (roughly the amount in 4-6 slices of bread) for at least 2 weeks prior to either the blood antibody testing or the endoscopy/biopsy. To put it another way, more recent guidelines seem to advocate a higher amount of daily gluten for a shorter period than did the older guidelines. To be sure of producing valid test results, however, I would go for 10g of gluten for four weeks for either kind of testing. That's my input.

I would aim for follow-up antibody testing after the first 6 months to check for compliance with the gluten free diet. There is a learning curve there. After you get that down, maybe yearly.

Edited October 20 by trents

[FelicityM]

Ok, thank you for that.  Really appreciate it.

[Scott Adams]

Here is more info about how to do a gluten challenge for a celiac disease blood panel, or for an endoscopy:

Quote

"...in order to properly diagnose celiac disease based on serology and duodenal histology, doctors need patients to be on gluten-containing diets, even if they are causing symptoms, and this is called a "gluten challenge."

• Eat gluten prior to celiac disease blood tests: The amount and length of time can vary, but is somewhere between 2 slices of wheat bread daily for 6-8 weeks and 1/2 slice of wheat bread or 1 wheat cracker for 12 weeks 12 weeks;
• Eat gluten prior to the endoscopic biopsy procedure: 2 slices of wheat bread daily for at least 2 weeks;

and this recent study recommends 4-6 slices of wheat bread per day: