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Biopsy Report


RVluvin

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RVluvin Apprentice

Went to the follow up visit today since my biopsy was done. Maybe an advanced member will understand it more than what I can make from it:

Diagnosis: Features suggestive of celiac disease, Marsh Type IIIB.

Microscopic description: The sections through the duodenal biopsy show fragments of ducdenal mucosa with marked villous atrophy. There is crypt hyperplasia and an intraepitheial lymphocytosis that measures greater then 40 intraepithelial lymphocytes per 100 enterocytes. The lamina propria contains an increase in the number of mononuclear cells, particularly lymphocytes and plasma cells. There is no evidence of neoplasia associated with these changes. There is no evidence of peptic duodenitis or microorganisms.

Doctor wants to do an other biopsy in 6 months. I'm not so sure I'll go along with that. What do you think?


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Booghead Contributor

The sections through the duodenal biopsy show fragments of ducdenal mucosa with marked villous atrophy. I believe this means you have blunting of the villi. Congrats sounds like you have Celiacs! Go off gluten. I think the second biopsy is to prove that your celiacs has started to heal. I read bout how they used to diagnose celiacs: positive biopsy on gluten, negative biospy off gluten(6 months later), reintroduce gluten and have another positive biopsy 6 months later. Sounds like your doctors are either old school or I am misunderstanding what they want to do.

If you are out of high school and out of college you don't need a diagnosis. If you already have one then you don't need one.

Either way go off gluten and if you feel better stay off gluten. Might need to go off dairy for a while to. (I am currently struggling with this one).

If you trust your doctors then do it. The biopsys aren't too bad (though I was in pain the next day after mine). The cost is what hurts.

Your decision. This is just my knowledge. B) Good Luck

RVluvin Apprentice

My biopsy was 2 mo ago, I just now got around to doing the follow up. I've been both gluten and latoce free since the day after the biopsy. Doctor wants to do another biopsy to see a healed small intestine. I think he wants another $185 from me and what ever the insurance give him.

I was hoping all that jipperish ment more than I have the celiac disease.

Booghead Contributor

Celiacs isn't simple or small. It's not just celaics. Don't do that negative thinking to yourself, what do want? Stomach Cancer? :ph34r: I only know the top part of the report you posted. Whatever else is on there I have no clue.

mushroom Proficient

You don't have cancer, you don't have a duodenal ulcer, you don't have an overgrowth of bad microorganisms. (My best interpretation :) )

rosetapper23 Explorer

Looks like you have bonafide celiac. With regard to the future biopsy, personally I would take a pass on that. No reason...unless you're not feeling any better or are feeling worse. If you're feeling pretty good, then I see no reason for repeating the biopsy. Case closed.

Di2011 Enthusiast

Diagnosis: Features suggestive of celiac disease, Marsh Type IIIB.

Microscopic description: marked villous atrophy.

There is crypt hyperplasia and an intraepitheial lymphocytosis that measures greater then 40 intraepithelial lymphocytes per 100 enterocytes. The lamina propria contains an increase in the number of mononuclear cells, particularly lymphocytes and plasma cells. There is no evidence of neoplasia associated with these changes. There is no evidence of peptic duodenitis or microorganisms.

Open Original Shared Link

Try having a read through these. It might help you make sense of the lingo.

I'm no guru ((someone please confirm or advise?)) but it seems to me that "marked villious atrophy" doesn't mean nil or mild villious atrophy ie you have "marked" damage to your villi therefore you have Celiac.


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mushroom Proficient

I think the doctor wants to do the follow-up biopsy for his own curiosity (and enrichment). It is up to you whether you want to pay $185 to satisfy it. If you heal when off gluten, you KNOW what your problem is. You don't really need him to see for himself. Your report says that you have celiac disease, and that there is nothing else going on in there that is detectable by the biopsy. :)

psawyer Proficient

Your results indicate Marsh IIIB. The Marsh scale measures the degree of damage to the villi. It ranges from I (minimal damage) to IV (total destruction). You have (or had) severe damage to your villi. The probable cause is celiac disease.

RVluvin Apprentice

I thought that maybe there was an explaination to what degree of damage I had incured, or various degrees of celiacs. By the 3rd day of being gluten free, I knew this was the cure I had been searching for most of my life.

I'm glad to see that others agree with me that a second biopsy in 6 mo was in his best interest, not mine. Thanks!!

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    • par18
      Thanks for the reply. 
    • 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.
    • Scott Adams
      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.
    • Seaperky
      I found at Disney springs and Disney they have specialist that when told about dietary restrictions they come and talk to you ,explain cross contamination measures tsken and work with you on choices. Its the one place I dont worry once I've explained I have celiac disease.  Thier gluten free options are awesome.
    • Churley
      Have you tried Pure Encapsulations supplements? This is a brand my doctor recommends for me. I have no issues with this brand.
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