Can H Pylori Give False Positive On Endoscopy Biopsy?

[Prairigirl]

I went in to the doctor three weeks ago with severe stomach pains, diarhea, etc. I tested positive for H Pylori but was ordered to have a colonosoy and Upper Gi. I also was told I needed to have my gallbladder removed which I did. I went on Prevpak for two weeks (and had the colonoscopy/upper GI while on prevpac). I just got the biopsy report back which showed that I showed "early" signs of celiac. Would the h pylori make the biopsy look positive for celiac when I really don't have it? Blood work was negative for celiac.

[T.H.]

Would the h pylori make the biopsy look positive for celiac when I really don't have it? Blood work was negative for celiac.

To the best of my knowledge, no. Quite a number of Celiacs have H. Pylori infections, so it's pretty common to have the biopsy while infected with this. I have two in my own family, actually. I have never heard of any damage by the H. pylori that mimics the damage done by our own bodies when we have Celiac Disease. Someone might have other information contradicting that, but honestly, I've never heard of anything.

And re: the negative blood work - There is a percentage of celiacs who have negative blood work and are only diagnosed through biopsy. And some who test negative to both tests but have symptom resolution on a gluten free diet, anyway (I guess their bodies didn't realize they had to pass a test first and didn't study. ) However, most of those with negative blood work take YEARS to get diagnosed, because many doctors refuse to test further once the blood work is negative.

So, short answer - sorry, hon, you've got Celiac Disease.

Good answer - though the diet is a pain, it's likely you will feel so much better after you get on this diet. :-)

[Looking for answers]

No, hpylori is VERY common and does not cause that kind of damage. I have hpylori as well. I've kept it in control though dietary changes only.

[Prairigirl]

Oh man--thank you both for your replies. I really was hoping that I didn't have celiac. The very idea of those kind of dietary changes is making me panic. Thanks you once again.

[ravenwoodglass]

Oh man--thank you both for your replies. I really was hoping that I didn't have celiac. The very idea of those kind of dietary changes is making me panic. Thanks you once again.

Don't panic. It is going to be life changing but in a good way. Read as much as you can here and ask any questions you need to. Some of us do go through withdrawl so if your a bit moodier than usual that is normal. If you have any favorite foods that are gluten filled do ask and likely someone will know of a replacement. Your not alone there are a lot of us and more are being diagnosed everyday so it is getting easier. I hope your feeling better soon.

[Cboogy]

I went in to the doctor three weeks ago with severe stomach pains, diarhea, etc. I tested positive for H Pylori but was ordered to have a colonosoy and Upper Gi. I also was told I needed to have my gallbladder removed which I did. I went on Prevpak for two weeks (and had the colonoscopy/upper GI while on prevpac). I just got the biopsy report back which showed that I showed "early" signs of celiac. Would the h pylori make the biopsy look positive for celiac when I really don't have it? Blood work was negative for celiac.

Yes, it can cause increased IELs, which is also a warning sign of Celiac Disease. Here are a few research articles explaining:

 

Open Original Shared Link

 

Open Original Shared Link

 

Open Original Shared Link

[1desperateladysaved]

My functional medicine nurse told me that H-Pylori is a organism that lives mainly in the stomach and causes ulcers..

 

Dee

[beth01]

h-pylori might cause increased IELs but it will not cause the atrophy of the villi.

 

The study/research that is posted above is from 2006 and clearly states that only 17 people out of the original 639 were included in the final research. Only 2% of the initial 639 were celiacs, which it doesn't state how many of them actually made it into the final 17.  This study also only deals with the IELs and doesn't state anywhere the correlation of atrophied villi. 17 people doesn't make scientific research in my opinion.

[Cboogy]

h-pylori might cause increased IELs but it will not cause the atrophy of the villi.

 

The study/research that is posted above is from 2006 and clearly states that only 17 people out of the original 639 were included in the final research. Only 2% of the initial 639 were celiacs, which it doesn't state how many of them actually made it into the final 17.  This study also only deals with the IELs and doesn't state anywhere the correlation of atrophied villi. 17 people doesn't make scientific research in my opinion.

I am not referring to villous atrophy, as that is the Gold standard for Celiac diagnosis.  Maybe all of these sites are out of date, but I thought it could still be a possibility to rule out. My apologies. Open Original Shared Link

[beth01]

No need to apologize. For one, I just noticed this was from March and they probably already have their answer.  I just didn't want to give anyone false hope. I really don't think doctors diagnose Celiac based on increased IELs alone, and the OP didn't state just what the findings of the endoscopy was.  I didn't want them confused.  We're all here to help

[Cboogy]

No need to apologize. For one, I just noticed this was from March and they probably already have their answer.  I just didn't want to give anyone false hope. I really don't think doctors diagnose Celiac based on increased IELs alone, and the OP didn't state just what the findings of the endoscopy was.  I didn't want them confused.  We're all here to help

The reason I'm following this topic is because a few weeks ago I was diagnosed with Celiac based solely on elevated IELs, so I am really scrambling to understand because everything I've been reading does not match my test results or experiences. Talk about frustrating. I had negative blood work and I'm not IgA deficient, so I tried eating a high-gluten diet for two months for a retest and my antibody levels actually went DOWN, and my symptoms seemed to be getting better. I'm waiting for the Dr. to call me back about that one. Before the endoscopy I'm told villous atrophy is what they're looking for. Then they say "Weeeeeeeell, lymphocytes are sort of a positive result too." Then I'm told the bloodwork will "definitely show something" and then when the results come back negative they're like "Weeeeeeeell, that's still possible." I just wish they'd give me some more concrete evidence if I'm required to make a lifelong decision to be strictly 100% gluten free. 

[beth01]

Maybe you can start a topic about diagnosis based on increased IEL's to see if anyone else was diagnosed that way.  Have you gotten a second opinion?

[Cboogy]

Maybe you can start a topic about diagnosis based on increased IEL's to see if anyone else was diagnosed that way.  Have you gotten a second opinion?

My new doctor says I do NOT have Celiac disease based on my history. According to his research only 12-20% of patients with elevated IELs actually have celiac, so you cannot diagnose Celiac based on this result alone. At least not without ruling out all other possible causes for the IELs (there are several). In fact, he performed some simple tests (breath and blood analysis) that previous doctors neglected or refused to offer me, which revealed lactose intolerance, H. Pylori antibodies and carnitine deficiency. Feeling much better now that I'm being treated for the correct diagnosis! And also less frustrated! 

[murphy203]

So what is an IEL? And wwhat were you dxd with? Sounds like you are seronegative, as am I. what specifically led you to conclude it isnt celiac disease?

[Cboogy]

My understanding of an IEL (intraepithelial lymphocyte) is that it is just a type of white blood cell that indicates inflammation of whatever tissue it is found in. I went from an old diagnosis of Celiac to a new diagnosis of lactose intolerance, carnitine deficiency and likely H. Pylori. I am having my blood celiac panel rechecked now that I've been on a gluten challenge for basically 9 months. It could come back positive for celiac disease, but if it's negative we will all be convinced that I never had celiac in the first place. 

 

There are many reasons for doubting the original diagnosis. Going gluten free made literally no difference in my symptoms. So eventually I saw a nutritionist and other docs for a 2nd and 3rd opinion and they've informed me that there is literally nothing in my medical record leading to a Celiac diagnosis. They said the original tests I have on record are meaningless and they do not even order those anymore. I never even had an endoscopy with the original diagnosis, and when I finally did have it done there was no villous atrophy. The original doctor ran the wrong blood tests (tests that are not highly specific to celiac disease), and also ran tests that are considered alternative and quacky, which makes us highly suspicious of the accuracy of his diagnosis. My new doctor said it's "embarassing" how little some of my previous doctors understood what they were doing. The doctor that did my upper endoscopy never even took a gastric biopsy, which should be standard procedure! Now I'm having to go through 3 more tests because of that. Smh...

[murphy203]

Interesting -- thanks for posting the additional information! I totally get why you want more evidence before you accept a diagnosis -- hopefully the next endoscopy and biopsies will provide you with some clinical evidence one way or the other.