Endoscopy Query

[marklen]

Hi,

I just had my endoscopy done following two highly celiac suggestive blood tests (through the roof would be a better description). When I came out it was still a bit of a blur but I remember my GI seeming a little deflated afterwards. He said because of my strong immune reaction he expected my small intestine to resemble cobblestones, but instead only found 'some changes' that he could see during the endoscopy. The biospy results aren't back for another week, however I was wondering whether it could potentially be something else. I thought the IgA tests were quite celiac specific but could there be another condition that could elevate IgA to such high levels?

Thanks,

Mark

[cyberprof]

Hi,

I just had my endoscopy done following two highly celiac suggestive blood tests (through the roof would be a better description). When I came out it was still a bit of a blur but I remember my GI seeming a little deflated afterwards. He said because of my strong immune reaction he expected my small intestine to resemble cobblestones, but instead only found 'some changes' that he could see during the endoscopy. The biospy results aren't back for another week, however I was wondering whether it could potentially be something else. I thought the IgA tests were quite celiac specific but could there be another condition that could elevate IgA to such high levels?

Thanks,

Mark

Mark, I don't know about the IgA test reliability, but I think docs like to have things cut-and-dried positive. My father-in-law and brother are both doctors and that's how they think. My own biopsy was negative visually (no blunted villi) but showed inflamation at the cellular level. Since he saw "some changes" I would say that you will probably have a Celiac-positive result, but unfortunately you have to wait for the answer.

[marklen]

Mark, I don't know about the IgA test reliability, but I think docs like to have things cut-and-dried positive. My father-in-law and brother are both doctors and that's how they think. My own biopsy was negative visually (no blunted villi) but showed inflamation at the cellular level. Since he saw "some changes" I would say that you will probably have a Celiac-positive result, but unfortunately you have to wait for the answer.

Thanks so much. I think the thing I hate most about the whole diagnosis is the whole waiting part! Never eating pizza again I can handle but one week waiting for pathology results kills me!

[ravenwoodglass]

I know it is hard to wait for a biopsy report. If the doctor was able to see changes with the aid of only the scope chances are there will be definate changes seen in the biopsy if the doctor took enough of them and if they were taken from a place being actively affected. There are times when the biopsy will show an inconclusive or even a false negative result, there are over 22 ft of small intestine and the damage can be in areas that are not biopsied.

I hope your doctor has encouraged you to try the diet no matter what the biopsies say, since you are done with the biopsy you can start now. Dietary resolution of your difficulties is the most conclusive test there is. It does not mean you can't ever have a pizza again, there are many good replacements nowadays for gluten foods like bread and pizza crust. Although at first you are best off going with whole naturally gluten free foods like meat, rice, potoatoes, fruits and veggies.

[Luisa2552]

My GI doc told me everything looked fine after my endoscopy. As you see in my signature my blood tests were split results. After the blood tests but before biopsy I did a 2 week trial on the diet and had great results. Then back on gluten for 6 weeks for biopsy. Results come back as blunted villi (remember doc told me everything was fine) and doc STILL not convinced I had celiac disease. I went gluten-free anyway and had the genetic blood test which came back positive which FINALLY convinced my doc I had celiac disease. I was convinced after the great response to the diet.

[happygirl]

Which IgA was elevated?

There is AGA IgA, tTG Iga, EMA Iga, and total IgA.

[marklen]

Which IgA was elevated?

There is AGA IgA, tTG Iga, EMA Iga, and total IgA.

Hi,

The initial gliadin IgA test was greater than 100 (normal range 0-20), the tTG (ISA) test was 300 (normal range 0-40).

Cheers,

Mark

[2kids4me]

Hi,

I just had my endoscopy done following two highly celiac suggestive blood tests (through the roof would be a better description). When I came out it was still a bit of a blur but I remember my GI seeming a little deflated afterwards. He said because of my strong immune reaction he expected my small intestine to resemble cobblestones, but instead only found 'some changes' that he could see during the endoscopy. The biospy results aren't back for another week, however I was wondering whether it could potentially be something else. I thought the IgA tests were quite celiac specific but could there be another condition that could elevate IgA to such high levels?

Thanks,

Mark

Wait for the results. My daughters biopsy looked quite normal during the procedure, the GI doc came out and said "her intestinal wall looks quite normal but we will wait for the biopsy to confirm that. Prior to the biopsy she was barely positive on antiendomeseal antibodies.

The biopsy was unmistakably celiac - with patchy areas of subtotal villous flattening and lymphocytic infiltration. GI doc commented that he didnt see visible damage and was glad he followed his own protocol to take several samples. Normally he took only 3 - 4. With our daughter - he took 5 in the duodenum plus some from the "antrum" - near the stomach, so that he didnt miss something.

The histology will reveal whats happening that the naked eye cant see.

Sandy

[marklen]

Wait for the results. My daughters biopsy looked quite normal during the procedure, the GI doc came out and said "her intestinal wall looks quite normal but we will wait for the biopsy to confirm that. Prior to the biopsy she was barely positive on antiendomeseal antibodies.

The biopsy was unmistakably celiac - with patchy areas of subtotal villous flattening and lymphocytic infiltration. GI doc commented that he didnt see visible damage and was glad he followed his own protocol to take several samples. Normally he took only 3 - 4. With our daughter - he took 5 in the duodenum plus some from the "antrum" - near the stomach, so that he didnt miss something.

The histology will reveal whats happening that the naked eye cant see.

Sandy

Pathology results came back and the GI said they were negative. Completely confused now, given the definitive serology. Wondering whether it might be something else. In any case I will go on the gluten free diet and see if it has any affect.

Thanks everyone for their advice.

Mark

[cruelshoes]

The initial gliadin IgA test was greater than 100 (normal range 0-20), the tTG (ISA) test was 300 (normal range 0-40).

Those numbers are highly suggestive of celiac disease, especially the very high TTG. How many endoscopy samples did your GI take? Damage can be spotty, so if he only took a sample or two, he may have hit on a less damaged portion.

Good luck on your gluten-free trial. The results of your dietary trial are just as important as the endoscopy, IMO. Results on a gluten-free diet are one part of the diagnosis process.

I hope you get some answers soon.