Is Endoscopy Needed?

[amlance]

I have just been told I have celiac disease by a positive in my blood work. Is it necessary to do an endoscopy? I have been on a gluten free diet for 3 weeks and have no diarrhea unless I accidently ingest gluten. I have found on my own that gluten was the culprit to my problems. The bloodwork was taken when I was ingesting gluten but time has elapsed since then. I really don't want to have to do an endoscopy if not necessary.

[mushroom]

I have just been told I have celiac disease by a positive in my blood work. Is it necessary to do an endoscopy? I have been on a gluten free diet for 3 weeks and have no diarrhea unless I accidently ingest gluten. I have found on my own that gluten was the culprit to my problems. The bloodwork was taken when I was ingesting gluten but time has elapsed since then. I really don't want to have to do an endoscopy if not necessary.

The choice is entirely yours. Most doctors want to do the endoscopy because it is the so-called "gold standard" of diagnosis, but if you are not having any other problems after being on the diet for three weeks, probably the only purpose it would serve would be to incur more medical expense and make the doctor feel better. Also, having been gluten free for three weeks, some healing has taken place and you would have to go back on gluten for six weeks for the reading to be valid. (Some doctors are not aware of this.) The biopsy was the only method of diagnosis prior to the development of the blood test and doctors seem to cling to it as being the only "valid" test, with the blood test merely the indication to do the endoscopy. A good percentage of the people here have not had the endoscopy, and some are entirely self-diagnosed without even the blood test, so no, you do not *need* the biopsy, especially with positive response to the diet. If at a later date you are still experiencing GI issues separate from the gluten, you can always go ahead and have the endoscopy then. Bear in mind that in order for the biopsy to be considered positive, there must be a great deal of damage visible in the intestine, measured on the Marsh scale of I-IV, you have to be a III to be considered celiac diagnosed, so many biopsies come out negative after positive blood tests. Just things for you to consider in making your decision. Good luck whichever way you decide.

[ravenwoodglass]

I agree completely with the previous poster. IMHO if you have seen a good resolutions of symptoms and you have had positive blood work and you have been made ill by the times you have accidentilly gotten gluten, well you really have your diagnosis.

[ksymonds84]

Mushroom had great advice but wanted to add if you are the type of person who will question your diagnoses in the future, its better to do all the testing available. I was like that and had a "wishful thinking" that I really wasn't Celiac. I had to do an awful gluten challenge ect last summer to prove that I did indeed need to do this diet for life. If you can accept that you are celiac with just the blood test and never look back, then you don't need an endoscopy.