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Do I Need A Biopsy?


deena647

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deena647 Apprentice

Hello, I am so happy to have found this site. I was given a blood test after I went in for a yearly physical a few weeks ago and I told my DR. that I thought I had a wheat allergy. The blood test came back positive. I do have times when I feel great and other times I rack my brain trying to think of what I did wrong in my eating. My DR. has not said any more about further testing, do I need to get a biopsy or is the blood test good enough? I have so many questions and I am thankful to have found you all......Deena


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psawyer Proficient

Welcome, Deena,

I am certainly not an expert on the blood tests--there are several. I was diagnosed by a biopsy almost six years ago. In those years, the blood tests have improved and it is now possible to make a clinical diagnosis based upon the results from a combination of tests for antibodies. I don't know the specifics, but I'm sure someone on here will step forward with them. A positive biopsy for damage to the villi is conclusive, but may not be necessary.

Search this board for Iga and Igg tests and you may find the answer, assuming you know which tests were run and what the results were.

Whether it is a wheat allergy, or celiac, you will find lots of help on here about following a wheat- and gluten-free diet.

MySuicidalTurtle Enthusiast

I only had a blood test but my brother had both to become diagnosed Celiacs.

ravenwoodglass Mentor
Hello, I am so happy to have found this site. I was given a blood test after I went in for a yearly physical a few weeks ago and I told my DR. that I thought I had a wheat allergy. The blood test came back positive. I do have times when I feel great and other times I rack my brain trying to think of what I did wrong in my eating. My DR. has not said any more about further testing, do I need to get a biopsy or is the blood test good enough? I have so many questions and I am thankful to have found you all......Deena

If your doctor is satisfied with the diagnosis without putting you through the endo be thankful. Just make sure you avoid topical glutens as well as foods, check you toiletries, shampoos, lipsticks et al. The folks here are wonderfully helpful and welcome to the family.

fastcatkerry Newbie

How do they perform the biopsy for Celiac? My doctor has told me I have DH and now is talking about doing a biopsy to test further. Is it similar to a colonoskopy?

KaitiUSA Enthusiast

Biopsies can only rule celiac in but not out so if it comes back negative you may still have celiac.

There is a full celiac panel that should be run and it is very accurate:

EMA

IgG

IgA

tTG

Total Serum IgA

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    • Scott Adams
      This is a very common question, and the most important thing to know is that no, Guinness is not considered safe for individuals with coeliac disease. While it's fascinating to hear anecdotes from other coeliacs who can drink it without immediate issues, this is a risky exception rather than the rule. The core issue is that Guinness is brewed from barley, which contains gluten, and the standard brewing process does not remove the gluten protein to a level safe for coeliacs (below 20ppm). For someone like you who experiences dermatitis herpetiformis, the reaction is particularly significant. DH is triggered by gluten ingestion, even without immediate gastrointestinal symptoms. So, while you may not feel an instant stomach upset, drinking a gluten-containing beer like Guinness could very well provoke a flare-up of your skin condition days later. It would be a gamble with a potentially uncomfortable and long-lasting consequence. Fortunately, there are excellent, certified gluten-free stouts available now that can provide a safe and satisfying alternative without the risk.
    • MogwaiStripe
      Interestingly, this thought occurred to me last night. I did find that there are studies investigating whether vitamin D deficiency can actually trigger celiac disease.  Source: National Institutes of Health https://pmc.ncbi.nlm.nih.gov/articles/PMC7231074/ 
    • Butch68
      Before being diagnosed coeliac I used to love Guinness. Being made from barley it should be something a coeliac shouldn’t drink. But taking to another coeliac and they can drink it with no ill effects and have heard of others who can drink it too.  is this everyone’s experience?  Can I drink it?  I get dermatitis herpetiformis and don’t get instant reactions to gluten so can’t try it to see for myself. 
    • trents
      NCGS does not cause damage to the small bowel villi so, if indeed you were not skimping on gluten when you had the antibody blood testing done, it is likely you have celiac disease.
    • Scott Adams
      I will assume you did the gluten challenge properly and were eating a lot of gluten daily for 6-8 weeks before your test, but if not, that could be the issue. You can still have celiac disease with negative blood test results, although it's not as common:  Clinical and genetic profile of patients with seronegative coeliac disease: the natural history and response to gluten-free diet: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606118/  Seronegative Celiac Disease - A Challenging Case: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9441776/  Enteropathies with villous atrophy but negative coeliac serology in adults: current issues: https://pubmed.ncbi.nlm.nih.gov/34764141/  Approximately 10x more people have non-celiac gluten sensitivity than have celiac disease, but there isn’t yet a test for NCGS. If your symptoms go away on a gluten-free diet it would likely signal NCGS.
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