Will A Dr See Celiac Through An Endoscopy?

[thegirlsmom]

My husband has recently been having a lot of issues with gluten and seems to have worse reactions to the stuff than I do who has been diagnosed with celiac. He is now gluten-free.

I just realized that about 2 years ago he had an endoscopy done because he had a feeling of something stuck in his throat that never went away. (He recently told me that after he got glutened that feeling felt worse again.) The DR said he didn't see anything and sent him home with anti anxiety meds.

My question is......would the DR have looked for celiac during this procedure or would he have stopped at his throat since that was the cause of his problems? And would he have been able to see celiac during this procedure or would he have to look specifically for celiac to find it?

[psawyer]

Only in extreme cases is the damage to the villi visible to the eye. In most cases, the detection of celiac disease is not by the doctor performing the endoscopy, but by the pathologist examining the tissue samples from the biopsy.

[algarve]

And importantly I think we want to know if there is an autoimmune response, so various blood tests make a lot of sense and are much more practical than endoscopy and taking biopsies. I tend to have a lot more to do with cancer, where I'm very cautious about biopsies, especially in places like the digestive system.

[Skylark]

And importantly I think we want to know if there is an autoimmune response, so various blood tests make a lot of sense and are much more practical than endoscopy and taking biopsies. I tend to have a lot more to do with cancer, where I'm very cautious about biopsies, especially in places like the digestive system.

Blood tests are available, but they pick up celiac about 75% of the time. The other 25% of the time, the antibodies (which are mostly in mucosal tissues) don't make it into the bloodstream. One of the celiac tests, anti-TTG is also not completely specific for celiac disease and can also be positive in ulcerative colitis and Crohn's. Doctors tend to want to do both blood and biopsy to be sure they have ruled out everything else and have a strong celiac diagnosis.

thegirlsmom, you wuold have to ask the doctor how far he looked with the scope. There are some classic visible signs of celiac in the small intestine like scalloping but not everyone has it. Celiac diagnosis is done with a biopsy to look at the state of the villi.

[algarve]

Blood tests are available, but they pick up celiac about 75% of the time. The other 25% of the time, the antibodies (which are mostly in mucosal tissues) don't make it into the bloodstream. One of the celiac tests, anti-TTG is also not completely specific for celiac disease and can also be positive in ulcerative colitis and Crohn's. Doctors tend to want to do both blood and biopsy to be sure they have ruled out everything else and have a strong celiac diagnosis.

thegirlsmom, you wuold have to ask the doctor how far he looked with the scope. There are some classic visible signs of celiac in the small intestine like scalloping but not everyone has it. Celiac diagnosis is done with a biopsy to look at the state of the villi.

I believe that anyone would be doing themselves a disfavour by eating (unfermented) grains, especially those containing gluten. Whether it's ulcerative colitis, Crohn's, celiac disease etc, gluten is potentially a major cause contributing to many different disease symptoms.

In my case, I'm IgA-deficient. My IgA has been 10 mg/dl (reference range 90-400 mg/dl) on the last 3 occasions, and my IgG is elevated and has ranged from 1930 to 2173 mg/dl (reference range 820-1740 mg/dl).

Celiac Disease and Immunoglobulin A Deficiency: How Effective Are the Serological Methods of Diagnosis?

ABSTRACT

Immunoglobulin A (IgA) deficiency is 10 to 15 times more common in patients with celiac disease (celiac disease) than in healthy subjects. Serological tests have become the preferred methods of diagnosing celiac disease in both symptomatic and asymptomatic patients. However, commercially available serological methods are limited in that they detect only the IgA isotype of antibodies (with the exception of IgG gliadin assays); hence, IgA-deficient patients with celiac disease may yield false-negative serology. Fifteen pediatric patients with celiac disease and 10 IgA-deficient pediatric patients without celiac disease were examined for IgA and IgG antibodies to endomysium, gliadin, and tissue transglutaminase. Twenty-five specimens from patients with IgA deficiency were examined. Fifteen were from patients with celiac disease, and 10 were patients without celiac disease. All 15 IgA-deficient patients with celiac disease were positive for endomysium antibodies of the IgG isotype and for IgG gliadin antibodies. All but one of the IgA-deficient patients with celiac disease were also positive for IgG tissue transglutaminase antibodies. None of the IgA-deficient patients without celiac disease were positive for any of the antibody markers. All the specimens examined were also negative for IgA-specific antibodies to endomysium, gliadin, and tissue transglutaminase. IgG-specific antibody tests for endomysium, gliadin, and tissue transglutaminase are useful for the identification of IgA-deficient patients with celiac disease. IgG antibody tests along with tests routinely being used in clinical laboratories can reliably detect all active patients with celiac disease. In addition, the levels of these celiac disease-specific IgG antibodies could be used to monitor patient dietary compliance.

(extracts)

Delays in the diagnosis of celiac disease may increase a patient