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Do I Need A Second Opinion?


maxwell1200

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maxwell1200 Apprentice

I was diagnosed on Tuesday being positive for celiac disease. They based this on a blood test alone. I have read many of the post and replies and can relate with so many of the stories and have the same symptoms. 10 years ago I was diagnosed with IB and been trying to deal with it and keep it under control. Now they say I have celiac disease, do I need a second opinion?

Angela


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gf4life Enthusiast

Hi Angela,

Your question about if you need a second opinion or not really depends. Are you questioning the validity of the bloodtests? Are you thinking that it might be wrong? It is a slim possiblity, but if you have symptoms and have previously been diagnosed IBS then the likelyhood of it being celiac disease is pretty high.

You might want to get a few more follow-up tests to check for nutritional deficiencies, and the only reason you would need a biopsy is to either have it as a pre-gluten free reference to compare with a future biopsy to check for improvement, or to convince a doctor that you do have celiac disease. If you doctor is willing to diagnose you based on the blood alone, then that would be okay in my mind. Of course the next doctor might tell you that you HAVE to have the biopsy to get a diagnosis. It is up to you to decide what is best for you.

There are problems with both the blood test and biopsy, but usually positive blood tests mean Celiac. It is the negatives that can often be false. It is like this: a positive test means positive for the disease, but a negative does not always mean negative for the disease, it can mean that you are not advanced enough with it to produce antibodies in the blood. The biopsy is not fail proof either. The damage can be spotty and it takes a skilled (and lucky) doctor, taking many tissue samples in the right places, to get an accurate diagnosis. If the doctor doesn't take enough samples and fromt he right places then you end up with a negative biopsy and are back to the IBS diagnosis.

If you feel the diagnosis is accurate, and you feel better off gluten, then I would go with that. But if you feel like you need a second opinion and a biopsy, then you had better stay on gluten while you seek those things, since going off of gluten will alter future test results.

God bless,

Mariann

maxwell1200 Apprentice

Thanks Mariann,

The test are probably right. I have only been gluten-free for 2 days. Ill give it time.

Angela

ys2kera Newbie

i need some help,,,,,, i have had 2 blood test and both came back pos for celiac disease one biopsy came back pos and the second after one month off the gluten free diet came back neg. What do i do?

darlindeb25 Collaborator
:unsure: i would go with the blood test--you may be gluten intolerant, maybe not full blown celiac yet and that is good--staying gluten-free will keep you from getting full blown celiacs--many times the blood work comes back celiac and the biospy comes back negative--i have read that so many times--gluten-free cant hurt you, but gluten may do damage you cant fix--i say, go gluten-free---deb :D
FreyaUSA Contributor

ys2kera, I'm not really certain what you're asking for help about. With 2 positive blood tests and one positive biopsy, you definitely have celiacs. My guess is that the follow up biopsy either was taken from an undamaged area or your time on the gluten-free diet has helped to heal you significantly enough that even with a single month off it, you are still far better off than you were. There's been much discussion on how long is needed off the diet to show damage. Obviously for you, one month isn't long enough (which isn't to say that it isn't hurting you in other ways.) Keep going gluten-free! It's working for you!

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      thank you RMJ! That is very helpful advice. Good to know we aren’t crazy if we don’t do the endoscopy. We are going to try the gluten free and see how symptoms and levels improve.    thank you Wheatwacked (love the username lol) that is also reassuring. Thankfully she has an amazing and experienced pediatrician. And yesss I forgot to mention the poop! She has the weirdest poop issues.    How long did it take y'all to start seeing improvement in symptoms? 
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    • RMJ
      So her tissue transglutaminase antibody is almost 4x the upper end of the normal range - likely a real result. The other things you can do besides an endoscopy would be: 1.  Genetic testing.  Unfortunately a large proportion of the population has genes permissive for celiac disease, but only a small proportion of those with the genes have it. With family history it is likely she has the genes. 2.  Try a gluten free diet and see if the symptoms go away AND the antibody levels return to normal. (This is what I would do). Endoscopies aren’t always accurate in patients as young as your daughter. Unfortunately, without an endoscopy, some doctor later in her life may question whether she really has celiac disease or not, and you’ll need to be a fierce mama bear to defend the diagnosis! Be sure you have a good written record of her current pediatrician’s diagnosis. Doing a gluten challenge for an endoscopy later in life could cause a very uncomfortable level of symptoms.   Having yourself, your husband and your son tested would be a great idea.  
    • Samanthaeileen1
      here are the lab ranges.  Normal ranges for tissue transglutaminase are: <15.0 Antibody not detected > or = 15.0 Antibody detected normal for endomysial antibody is < 1.5. So she is barely positive but still positive. 
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