Is A Biopsy Strictly Necessary?

[AudreyT]

Hello. My name is Audrey and I am new to the board. I recently suffered a 25 day bout of diarrhea...and my Doc suspects Celiac Disease.

I am scheduling the intital blood test(s). But I wanted to know if a biopsy is really necessary. I am nervous about the procedure, and also just having concerns about finding the time, etc. However, my health comes first, and I want to do the right thing here.

Any thoughts would be appreciated. Thank you.

[nikki-uk]

Getting the biopsy is a very personal thing.

There are many people on these boards that didn't - but they know through dietary response that when they eat gluten they feel ill.... and feel well off it.

There are however benefits to having the biopsy.

It can rule out any other 'nasties' the doc may be looking for.

Both my husband and son were diagnosed by biopsy.

It was our decision because it was irrefutable proof......I knew if there was an element of doubt it would make it harder to stick to being gluten-free for life.

Good Luck

[Lisa]

Hello. My name is Audrey and I am new to the board. I recently suffered a 25 day bout of diarrhea...and my Doc suspects Celiac Disease.

I am scheduling the intital blood test(s). But I wanted to know if a biopsy is really necessary. I am nervous about the procedure, and also just having concerns about finding the time, etc. However, my health comes first, and I want to do the right thing here.

Any thoughts would be appreciated. Thank you.

Welcome Audrey:

Your blood test can confirm Celiac, but they are not 100% reliable. Make sure that your doctor runs the full Celiac Blood Screening test. If you do have a positive blood test, there is no need for further diagnostic testing for Celiac. The endoscopy exam and biopsy can also confirm Celiac Disease and look for the extent of villi damage in the small intestines. The endoscopy exam can also look for other issues. The biopsy can be hit or miss and also is not 100%. It is not a difficult exam and there is nothing to worry about regarding the procedure.

It is very important, that while you await your blood screening that you remain on gluten. DO NOT GO GLUTEN FREE. It may effect your results.

I hope this was helpful.

[happygirl]

The endoscopy won't only be looking for Celiac. It will be looking to rule/in out other diagnoses, as well.

[wannaBAmama]

I had an endoscopy w/ biopsies last month despite negative blood work- I did blood tests one week after a 2 week gluten-free trial and was fearing a false negative. I responded so well to my gluten-free trial in November I really wanted to know if I had villi damage. The results just came back (see my other post re: endoscopy results) but the biopsies determined no villi damage but a high white blood cell count - doctor suspects small intestine bacterial overgrowth (which if left untreated, patients also can see a great response to going gluten free since the bacteria is feeding off of the gluten) - or if it's not bacteria, then very early celiac. I am now on antibiotics (xifaxan) to see if it is a bacteria issue and 3 days in I am feeling really good (I have been gluten-free since 12/22 but the antibiotics made me get more energy in the AM- which was surprising), so it's posible I am not gluten intolerant after all. I will remain off gluten and will also take some probiotics for a month or two before attempting to challenge any gluten but I honestly had not expected this possibility (I thought I was for sure genetically gluten sensitive and was ready to be off of gluten forever). Now I'm just taking things a day at a time. Assuming I will be able to ingest gluten again I'll probably remain gluten-free but not fear accidental glutenations (they suck- I was out of commision for a day and a half after accidentally having a corn tortilla that touched a flour tortilla).

So for me I am glad I did the biopsy. I have been trying to undersatnd my other health issues (infertility) and really wanted to get as much information as possible and the biopsy was part of my quest for answers.

I've had a lot of procedures as part of my infertility and the endoscopy was one of the simplest for me - the worst part was the preparation prior to it (I did a colonoscopy at the same time and was on the liquid diet for a day plus all the laxatives) - I barely remember the procedure itself and had no pain/effects afterwards.

Gina

[AudreyT]

Thanks to each of you for your responses.

Is there a type of blood test I should be asking for specifically? Or is there only one that needs to be done?

[Lisa]

Thanks to each of you for your responses.

Is there a type of blood test I should be asking for specifically? Or is there only one that needs to be done?

These are some or all of the tests your doctor may order:

IgG Antigliadin

IgA Antigliadin

tTG Antigliadin

IgG Tissue Translutaminase

IgA Tissue Transglutaminase

Total IgA

[AudreyT]

Thank you so much. Now I can be sure that I am getting the right tests. Thanks again!

[happygirl]

The tests that you want run are: Open Original Shared Link

Anti-gliadin antibodies (AGA) both IgA and IgG

Anti-endomysial antibodies (EMA) - IgA

Anti-tissue transglutaminase antibodies (tTG) - IgA

Total IgA level.

If you are IgA deficient, they will often run the tTG IgG.

[JennyC]

These are some or all of the tests your doctor may order:

IgC Antigliadin

IgA Antigliadin

tTG Antigliadin

IgC Tissue Translutaminase

IgA Tissue Transglutaminase

Total IgA

You mean:

IgG Antigliadin

IgA Antigliadin

tTG Antigliadin

IgG Tissue Translutaminase

IgA Tissue Transglutaminase

Total IgA

[Lisa]

You mean:

IgG Antigliadin

IgA Antigliadin

tTG Antigliadin

IgG Tissue Translutaminase

IgA Tissue Transglutaminase

Total IgA

Oooops, I'll go back and change it. Thank you ladies.

[d4rp]

These are some or all of the tests your doctor may order:

IgG Antigliadin

IgA Antigliadin

tTG Antigliadin

IgG Tissue Translutaminase

IgA Tissue Transglutaminase

Total IgA

`

Hi,

Do you need to be still eating gluten to have these tests show a proper DX?

[Lisa]

`

Hi,

Do you need to be still eating gluten to have these tests show a proper DX?

Yes, it's recommended to eat the equivalent of 3-4 slices of bread for at least two months.

[grommet]

I had an endoscopy w/ biopsies last month despite negative blood work- I did blood tests one week after a 2 week gluten-free trial and was fearing a false negative. I responded so well to my gluten-free trial in November I really wanted to know if I had villi damage. The results just came back (see my other post re: endoscopy results) but the biopsies determined no villi damage but a high white blood cell count - doctor suspects small intestine bacterial overgrowth (which if left untreated, patients also can see a great response to going gluten free since the bacteria is feeding off of the gluten) - or if it's not bacteria, then very early celiac.

You may want to have a look at this Open Original Shared Link.

It's a link to a write up on SIBO and a few messages from a UK based Coeliac forum.

Best Wishes in you endeavour to find out what is causing your problems.