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What Is Considered 'damage'


glutenfr3309

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glutenfr3309 Rookie

was wondering if anyone could explain to me what is considered damage when a biopsy of the small intestine is done.

when i had mine, after the endoscopy my GI doc said he saw damage but pathology results only show inflammation, no sign of sprue. is inflammation considered damage?

i've been trying to read more about the differences between non-celiac gluten intolerance and celiac but now i'm just confused.

i understand celiac is an auto immune disease but is it possible to have the brain fog, fatigue, itchy/dry skin, constant congestion in the sinuses, extra sensitivity to my thighs and other parts of my body (easy bruising) with a non-celiac gluten intolerance? i'm assuming these can be signs of vitamin deficiencies...

regardless i know i will see improvement with a gluten-free diet (which i have been instructed to do) but i haven't had blood work done to test for deficiencies yet.

edit: i have a history of depression and skin picking (started 20+ years ago). i'm starting to think that the whole gluten intolerance thing has something to with this!


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Pac Apprentice

was wondering if anyone could explain to me what is considered damage when a biopsy of the small intestine is done.

when i had mine, after the endoscopy my GI doc said he saw damage but pathology results only show inflammation, no sign of sprue. is inflammation considered damage?

i've been trying to read more about the differences between non-celiac gluten intolerance and celiac but now i'm just confused.

i understand celiac is an auto immune disease but is it possible to have the brain fog, fatigue, itchy/dry skin, constant congestion in the sinuses, extra sensitivity to my thighs and other parts of my body (easy bruising) with a non-celiac gluten intolerance? i'm assuming these can be signs of vitamin deficiencies...

regardless i know i will see improvement with a gluten-free diet (which i have been instructed to do) but i haven't had blood work done to test for deficiencies yet.

edit: i have a history of depression and skin picking (started 20+ years ago). i'm starting to think that the whole gluten intolerance thing has something to with this!

I've only been diagnosed with mild IgE allergy to gluten and had slight gut inflammation and yet I had all the "atypical" symptoms of celiac (everything except constant diarhea and losing weight). The theory is that all these things are a result of malnutrition or vitamin deficiencies due to gut damage, but I just don't believe in it. If I eat or even breath in gluten, these "atypical" symptoms including depression, fatigue, brain fog, ataxia appear within 5-24hours. There's no way you can get so severely malnourished in just a few hours.

Lisa Mentor

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How does Gluten Cause Damage?

Gluten triggers an abnormal immune response that flattens and alters the small intestinal villi. This decreases the lining's surface area and alters its absorptive abilities. Malabsorption of some or all nutrients occurs and the body cannot get the essential proteins, fats, carbohydrates, vitamins, and minerals necessary for good health. It is important to be aware that a tiny crumb of bread causes the same damaging response as a whole slice, because it takes only one molecule to trigger the destructive mucosal response.

Lisa Mentor

when i had mine, after the endoscopy my GI doc said he saw damage but pathology results only show inflammation, no sign of sprue. is inflammation considered damage?

A GI can see physical signs of damage, but a biopsy can miss effective areas and be inconclusive. Unfortunately, there are no tests available at this time that are considered 100%. Many times a diagnosis is cumulative through testing, dietary response and family history.

ravenwoodglass Mentor

If I eat or even breath in gluten, these "atypical" symptoms including depression, fatigue, brain fog, ataxia appear within 5-24hours. There's no way you can get so severely malnourished in just a few hours.

You, like myself sound like you have had neuro impact from the antibodies. For some symptoms like the fatigue and brain fog can be due to deficiencies but for some of us they are more due to brain impact. For those that have those type issues due to malabsorption they are not IMHO as likely to reoccur with an accidental glutening as they are with someone who has had the antibody neuro impact.

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    • 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.
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      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.
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