Question by Trixie: Why do doctors want to stick that thing down your throat and scrape your intestines to check for celiac?
What is the point of putting patients through that? If they have the symptoms just try the gluten free diet and if you get better then voila.
They won’t give you a confirmed diagnosis from the blood test alone though and I don’t get it. The biopsy procedure is painful and that thing that goes down your throat is the same one they use for colonoscopies I mean yuck.
Best answer:
Answer by Jonah
Because some patients (in fact, more than a third) don’t stick to the gluten free diet very well or find it very difficult, and once patients are eating gluten free, the endoscopy no longer accurately says if the patient had celiac.
Also, many patients think they are eating gluten free when they’re not, so they’ll think they don’t have celiac when the diet doesn’t help. Or they may truly be eating gluten free, but can still have it take months for them to feel better.
But you do have a point and many doctors agree with you, particularly since the blood test is accurate in more than 95% of cases.
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One reason is that originally, the blood tests for celiac disease could be celiac disease OR a handful of other conditions. However, they have come up with more celiac-specific blood tests recently, which mean that those are less likely to indicate celiac disease when it’s something else.
However, those tests, the more specific ones, don’t have as high an accuracy rating as the blood tests. Personally, I think a lot of it is CYA tradition that has built up over time.
In my own opinion, one should take the blood test, and then do the diet, and if there is no improvement, THEN do a biopsy to see what else it was. But that’s just me.
From a patient point of view, I agree. It’s stupid.
However, there are some people who test positive from the blood tests, but are negative on the biopsy. Thus they would not be diagnosed with Celiac Disease.
I have spoken to an Immunologist and he has dedicated his work to gluten and its role in immunity. He believes that those who have the genes positive are just ticking time bombs. Those who test positive for the antibodies, but negative for the biopsy should still go gluten free. He believes that the disease has no been active long enough to create the damage needed to make a diagnosis.
Also, the damage can be patchy and the biopsy can miss it.
If you’re concerned about getting an accurate diagnosis, then go through with the biopsy. If you don’t want to and feel better on a gluten free diet, then continue to eat that way.
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