Is A Biopsy Necessary For A Diagnosis?

[BushMommy]

So, I went to see my doctor today. She is such a great listener. I told her all my symptoms and she readily agreed to the serum test for IgA. We were discussing the high possibility of it having a false negative and she made the statement that regardless of the blood test, she had enough information to make a diagnosis.

I mentioned this to another friend with celiac disease and she said that my doctor was out of line and that I would have to have the endoscopy before a valid diagnosis was made.

Just wondering who is correct - or is this one of those grey areas?

[nvsmom]

Very grey area. LOL Some doctors are old school and want the biopsy, others consider positive blood work (especially ttg IgA and EMA) with or without symptoms enough. I was diagnosed without a biopsy and I know it's becoming more common.

I think biopsies are most useful for those who have negative blood work for what ever reason. Many have been diagnosed with just a biopsy and negative blood work....

Best wishes.

[GottaSki]

You don't need an endoscopy with positive blood work and symptoms. It has been the "gold standard" of diagnosis for a very long time, but this is changing.

I would be surprised that a doctor would diagnose you with Celiac Disease with negative blood work, unless you are IgA deficient. Other considerations would be severe nutritional deficiencies in blood work and whether you have already done a trial gluten elimination with positive resolution of symptoms. Although without some measurable positive test, it could be that your doctor was referring to a diagnosis of Non-Celiac Gluten Intolerance - which has no test other than resolution of symptoms after completely removing gluten.

Is a diagnosis of Celiac Disease or NCGI possible without endoscopic biopsy - yes. Let's be clear - most doctors will still require endoscopy to diagnose -- understanding of all things celiac is slowly improving and blood tests have become more accurate, but there is still a very long way to go to get the entire medical community on board.

[BushMommy]

I have done the gluten elimination diet and feel a million times better. I did a gluten challenge to TRY to get positive results on the blood work and feel like crap. So, at least that is in my favor.

Did not know about the Non-Celiac Gluten Intolerance bit. Good to know!

Thanks for the replies. I guess we'll see what's up when I get the results back.