I believe the sampling is from the villi in the intestine.

From reading the gluten posts for years, I think even some
biopsies can be negative and people still report the GF diet helps anyway. This is because the intestine is not all inflamed equally and patches may be missed.

You'll have to ask the doctor, if he plans on going past the stomach into the small intestine. The scope will show if
the stomach has inflammation or ulcers, etc.

Glenn knows more about the testing than I do.

Thank you Mrs.D. I hope Glenn will provide me with his knowledge.

If the intestine is not equally inflamed, do you think it will be advantageous to do the biopsy?

Usually they only do a biopsy if some of the blood work is iffy, or not strong.

Did you have all the blood tests already?

Gluten intolerance is less likely to be positive for GI biopsy.
Celiac is more severe, and there is usually a positive biopsy with them, but not 100% of the time as I have read.

I had tests for Gliadin IgG/IgA and IgA/IgG Tranglutaminase and all negative. I dont know if my results maybe considered as iffy. The only questionable about my result is the laboratory used the "deamidated gliadin". The Gluten File says:

A newer test, anti-deamidated gliadin, has been developed over the last several years and some labs are beginning to automatically substitute it instead of the original antigliadin antibody tests. The newer test is more specific to "celiac disease / villous atrophy", which is not helpful when looking for gluten sensitivity manifesting in non-gut ways (like neurological disease or other autoimmune disease), or when there are gut symptoms that have not yet caused villous atrophy. BE SURE your doctor orders the original antigliadin tests. DOUBLE CHECK that the right tests are ordered, and DOUBLE CHECK that the right tests were run. You want anti-gliadin IgA and anti-gliadin IgG, over anti-deamidated gliadin.... or all of them!

The reason why I had to ask about it again is because I read that Celiac/Gluten Intolerance may cause Sjorgren's. With all the new symptoms I am experiencing: dry eyes, mouth, throat and nostrils and more specially the fibronodules in my lungs - I was hoping to rule this condition out of my way...

Thank you

Keep in mind that an endoscopy is an invasive procedure.

If you don't have a strong indication for it, I'd just do the GF diet and see what happens over the next few months.

It is your choice after all.. but if you search endoscopy risks, you'll see what I mean.

Thank you MrsD. I don't want invasive procedures. Its just I am becoming too desperate.

--should be able at least not only to look at what is going on in the stomach, but in the duodenum, which does contain villi and from which samples can be taken.

Sometimes, evidence of frank celiac may be found there. But, as noted, the damage to villi may be patchy, and may occur farther down the small intestine. And a standard endoscopy may not get that far down--for one thing, a different, smaller scope may need to be used.

There were a spate of recent articles referencing a study concluding underdiagnosis of celiac due to lack of sufficient villous samples taken on "standard" small intestine biopsies--here's one link to it (and it gives the original study reference):

http://www.stonehearthnewsletters.co...nored/updates/