Inconclusive biopsy results

[Lizy487]

Hey everyone, I am 38 years old and have had a long term history of unexplained gastric issues including cramps, intermittent diarrhoea that causes very yellow stools, bloating, gas and so on. Endoscopy with biopsy 2 years ago was clear but colonoscopy revealed 15 polyps that were unrelated to my gastric issues??

Since that time my symptoms have only gotten worse despite cutting out dairy and introducing FODMAP.

Severe upper abdominal pain 2 weeks ago (new symptom) sent me to the GP who ran a number of tests and scans and then finally sent me for another endoscopy which revealed:

regenerative gastric mucosa with moderate chronic inflammation.

Mild to moderate chronic duodentitis

Villi are swollen, congested, and shorter.

Moderate number of lymphocytes present in the mucosa.

Moderate chronic duodenitis with loss of villi.

Prominent small capillary-like blood vessels seen in the lamina propria.

Inflamed mucosa of gastric type. Findings suggest moderate reflux oesophagitis.

Moderate chronic erosive duodenitis.

Despite all of the findings the conclusion report is inconclusive and suggests further serology, however my Dr believes there is enough significant evidence for him to diagnose me with coeliac disease. Obviously this is life changing news and I am unsure if I should be requesting further testing before changing my diet for the rest of my life.

If anyone could shed some light on my results and tell me what you think I would really appreciate it.

Maybe I’m just in denial lol

 

 

 

 

 

 

 

 

 

 

 

[plumbago]

The endoscopy you just had done - did it include biopsies? Or were the findings you cite what was observed by the person doing the scope? From the sounds of it, it seems like celiac is a likely possibility. Might as well get serology done.

18 minutes ago, Lizy487 said:

Prominent small capillary-like blood vessels seen in the lamina propria.

Which part of the GI tract was this? Small intestine? Something else?

Plumbago

[Lizy487]

The only thing that was visually seen was oesophagitis. The rest of the results are from biopsies.

The blood vessels were from the small intestine

[trents]

I would ask to have celiac antibody blood tests done. These tests would not be valid, however, unless you were eating normal amounts of gluten for weeks or months leading up to the blood draw. So, not sure how the FODMAP diet figures into that. Ask for a minimum of 1. total IGA and 2. TTG-IGA.

"Villi are swollen, congested, and shorter."

"Moderate chronic duodenitis with loss of villi."

These two lab findings you list are classic signs of celiac disease but can also have other causes.

Edited April 9, 2025 by trents

[Lizy487]

Thanks for the reply, I will ask for the antibody test. FODMAP does not eliminate gluten so it shouldn’t affect the results.

[trents]

In the time leading up to the blood draw for the antibody testing, attempt to consume at least 10g of gluten daily, about the amount found in 4-6 slices of wheat bread.

Concerning the two antibody tests I suggested, the "total IGA" is not a test per se to detect celiac disease but to check for IGA deficiency. If you are IGA deficient, the test scores for individual IGA tests will be artificially low and can generate false negatives. The TTG-IGA test is the most popular test ordered by physicians when checking for celiac disease, and considered to be the centerpiece of celiac disease antibody testing, but it is not the only one. Ideally, others would be ordered but cost containment in medicine being what it is, physicians seldom order a "full celiac panel" at the outset. Here is an overview of the tests that can be run: