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Blood Test And Endoscopy


Runner1978

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Runner1978 Rookie

In September, my blood tests were conflicting. One was positive for celiac, the other (apparently the more accurate) was negative. I believe I had a 5 on that one. I've been gluten free for two months. The diarhea has gone away, for the most part, I'm no longer nauseous and I do look healthier. That being said, I have alot of acid reflux and severe abdominal cramps every second day or so despite being gluten-free. So I saw a specialist who says I may or may not have celiac, I may just be gluten intolerant. He also says I may have crohns. My family doctor had tested me for crohns with a blood test and it came back negative. That said, the specialist says there is no blood test for crohns. So now I'm quite worried. I've started eating gluten again in preparation for an endoscopy. So far, I sill feel ok. I sometimes feel nauseoous but it's difficult to tell if these symptoms are real or imagined as I'd really rather have celiac than crohns.

My main frustration is that I can't get a straight answer. I'm not exactly sure what I'm asking with this post. Perhaps a bit of guidance on my positive/negative blood test.


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BRob66 Rookie
In September, my blood tests were conflicting. One was positive for celiac, the other (apparently the more accurate) was negative. I believe I had a 5 on that one. I've been gluten free for two months. The diarhea has gone away, for the most part, I'm no longer nauseous and I do look healthier. That being said, I have alot of acid reflux and severe abdominal cramps every second day or so despite being gluten-free. So I saw a specialist who says I may or may not have celiac, I may just be gluten intolerant. He also says I may have crohns. My family doctor had tested me for crohns with a blood test and it came back negative. That said, the specialist says there is no blood test for crohns. So now I'm quite worried. I've started eating gluten again in preparation for an endoscopy. So far, I sill feel ok. I sometimes feel nauseoous but it's difficult to tell if these symptoms are real or imagined as I'd really rather have celiac than crohns.

My main frustration is that I can't get a straight answer. I'm not exactly sure what I'm asking with this post. Perhaps a bit of guidance on my positive/negative blood test.

My naturopathic doctor did a blood test,,allergy testing and a saliva test. In my opinion medical doctors don't test for this enough. they usually do the small bowel biopsy,,but I have been told that if you are off gluten/wheat for a while the tests can be negative and conflicting. In the past I was diagnosed with IBS,depression,and environmental allergies. also the villi in the small bowel can be damaged and you can have other food related reactions. i am currently soy free,egg free and dairy free. I also hear some of the syptoms are like crohn's disease and that if untreated celiacs can cause crohns. good luck

Fiddle-Faddle Community Regular

If you have been gluten-free for 2 months, you will need to eat a LOT of gluten for 3 months in order to damage your villi (which healed in those 2 gluten-free months) enough to have a positive biopsy result.

There has been a lot of talk lately about the problems with biopsy--I hope you can find all the discussion on some of the other recent threads on this board! But biopsy is NOT a reliable way to rule out celiac, as there is the potential for a huge possibility of false negatives. This is especially true if you have already been off gluten for more than a month.

happygirl Collaborator

However, if your doctor takes multiple biopsies from multiple places, it increases the possibility of an accurate biopsy reading.

I would recommend that before/at the time of the biopsy (since you are eating gluten again), to have the full Celiac blood panel run. It involves five tests:

AGA IgA

AGA IgG

EMA IgA

tTG IgA

Total IgA.

This way you'll have the biopsy and the full Celiac bloodwork run to help in making an educated decision. Best of luck.

Runner1978 Rookie

If I understand correctly, the blood tests are to identify anti-bodies related to the disease. How can one test be positive without meaning I have it?

happygirl Collaborator

There are different tests in the Celiac blood panel and none of them, individually, are 100% sensitive and 100% specific to Celiac. That is why they recommend the full panel.

While the severity of the damage is often correlated to parts of the Celiac panel (I forget if it is EMA or tTG), you can still have a negative blood test and be positive on biopsy, and vice versa.

If you post the names of the tests, the score, and the range, we can help interpret.

  • 6 months later...
kifert Newbie

my blood tests for celiac came back fine, but my gastroenterologist wants to do an endoscopy while she's got me there for the colonoscopy...My daughter has celiac, but I have no symptoms. does doing the endoscopy make sense?


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aikiducky Apprentice

Kifert, absolutely it makes sense, especially if you're going to be having a colonoscopy anyway. Bloodtests aren't all that reliable, they are only reliably positive in people who have extensive damage to their intestines. If you are in the earlier stages of celiac your blood test might be a false negative but the endoscopy might find some damage. Ask them to take plenty of samples though, because just a couple of samples might miss damage if it's spotty.

Pauliina

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    • par18
      Thanks for the reply. 
    • Scott Adams
      What you’re describing is actually very common, and unfortunately the timing of the biopsy likely explains the confusion. Yes, it is absolutely possible for the small intestine to heal enough in three months on a strict gluten-free diet to produce a normal or near-normal biopsy, especially when damage was mild to begin with. In contrast, celiac antibodies can stay elevated for many months or even years after gluten removal, so persistently high antibody levels alongside the celiac genes and clear nutrient deficiencies strongly point to celiac disease, even if you don’t feel symptoms. Many people with celiac are asymptomatic but still develop iron and vitamin deficiencies and silent intestinal damage. The lack of immediate symptoms makes it harder emotionally, but it doesn’t mean gluten isn’t harming you. Most specialists would consider this a case of celiac disease with a false-negative biopsy due to early healing rather than “something else,” and staying consistently gluten-free is what protects you long-term—even when your body doesn’t protest right away.
    • Scott Adams
      Yes, I meant if you had celiac disease but went gluten-free before screening, your results would end up false-negative. As @trents mentioned, this can also happen when a total IGA test isn't done.
    • Seaperky
      I found at Disney springs and Disney they have specialist that when told about dietary restrictions they come and talk to you ,explain cross contamination measures tsken and work with you on choices. Its the one place I dont worry once I've explained I have celiac disease.  Thier gluten free options are awesome.
    • Churley
      Have you tried Pure Encapsulations supplements? This is a brand my doctor recommends for me. I have no issues with this brand.
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