Once Iga Test Is Pos., What's The Point Of Biopsy?

[shirleyujest]

Are you assessing the damage that's been done or what? I realize this may be in a book, I have reserved the Green book on Celiac but it hasn't come in yet. Thanks in advance.

[heathen]

In the strictest medical terms, small bowel biopsy is the "gold standard" for a diagnosis of Celiac disease--which basically means that this is the best test we have currently, and the medical field IN GENERAL will not recognize the diagnosis without a positive biopsy. Of course, some people who really do have Celiac Disease can have a negative biopsy depending on several variables, so it's not a perfect test by any stretch. Ideally, once we get more research and better blood tests that are more sensitive and specific for Celiac Disease, the biopsy will not be as needed and the "gold standard" will change, but this will take time. And you're right--it can give a good indication of the damage that has taken place.

[ravenwoodglass]

Heathen gave you a good answer. The choice whether to biopsy or not is yours. As stated the damage can be missed in the biopsy leading to a false negative. There are also changes that are seen before the villi are destroyed that unfortunately not all GI's recognize. There are folks who will not be compliant with the diet without a positive biopsy, a tragedy IMHO if the diet is needed. Some people have also had trouble with insurance companies after a firm biopsy proven diagnosis, not always the case but it has happened. It is very important that you continue on gluten until the biopsy is done if you are going to have one. It is up to you whether you want the procedure or if you just want to go gluten free without one. The relief from symptoms is a good indicator of the need for the diet and after the biopsy you should go strictly gluten free no matter what the biopsy results are. At times the body can give an answer that is better than any of the tests that we currently have available.