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Test Results - Why Do I Need A Biopsy?


susanm

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susanm Apprentice

Hi, here are my test results:

Antigliadin antibody, IgG - 64 units (normal 0-19)

Antigliadin antibody, IgA, - 41 units (normal 0-19)

My doctor is on vacation, but I got a letter saying I "may" have celiac disease and that I should call a GI doctor for a biopsy. I really don't want them to put a scope down my throat, but if I have to, I will.

Why aren't these blood tests enough? Also, it's probably going to be several months before I actually get the biopsy. Should I start eating gluten again? I've only been gluten-free a week and a half.


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Tim-n-VA Contributor

Celiac is a disease that overlaps symptoms with other diseases. Some other diseases, especially auto-immune diseases could cause a false positive on the blood tests.

A positive biopsy along with a positive blood test mimimizes the chance of a false diagnosis that could happen with just blood tests.

Many people one this site will tell you that a positive dietary response is the best test. That is true from a "what should I eat" perspective. It is not true from a "which body subsystem is causing the problem" perspective.

The real bottom line is that you should stay on gluten until you have the level of medical testing that you will need for yourself. The worst case is to go gluten free and then decide you want a definitive diagnosis and have to go back on gluten. There are two or three threads per week started here where people went gluten free and are facing the decision to add it back to their diet for a test. Those who try that usually have terrible symptoms and have trouble maintaining the gluten diet long enough for the body to react enough to register on a test.

The main reason that you might want the definitive diagnosis is that diseases frequently occur in clusters and knowing you have celiac versus a gluten allergy would be a hint for further issues to watch.

At least in the US, some doctors will be hesitant to make a diagnosis without definitive tests (i.e. biopsy) because of the risk of lawsuits.

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