[JohnDory]

thanks for the reply,

I have stopped eating gluten, but haven't felt much better. I'm not sure if I should start eating gluten again for the test? My doc didn't tell me too. I would have thought that if I have effected intestines by gluten then they won't heal in a month or so time, so should still get a positive result.

My main reason why I don't think I have intestine probs due to gluten is that the other antibody tests came back negative.

Will see once the test gets done anyway.

[jccgf]

I've known several biopsy proven celiacs who had only a positive antigliadin IgG. It is absolutely possible.

According to several studies, as many as 20% of biopsy proven celiacs do not show positive anti-tTG or anti-endomysial, especially if there is only partial villous atrophy.
http://jccglutenfree.googlepages.com...testsandbiopsy


Being gluten free for a week or two before biopsy may not affect your biopsy results, but longer might. You need to be eating gluten for accurate blood and biopsy results. I know blood antibodies can normalize very quickly...falling sharply within one month.
Antibody levels in adult patients with coeliac disease during gluten-free diet: a rapid initial decrease of clinical importance. PMID: 15554953

How quickly do the intestines heal??? I'm not sure I've seen anything concrete on that, but it likely depends upon the degree of damage. Severe damage may not heal in weeks (in fact, can take 6-12 months or longer), but mild damage may heal more quickly. I'm going to look around to see if I can find any studies or articles that address this specifically.

How long have you been gluten free already, and how soon is the biopsy scheduled?

[jccgf]

Histologic recovery of small intestinal mucosa is assumed to occur within 6 to 12 months after starting a gluten-free diet, simultaneously with clinical remission. Surprisingly, follow-up data on small intestinal recovery in celiac disease are scarce and contradictory.
http://www.medscape.com/viewarticle/440971

This particular study only looked at 2yr and 5yr follow up periods, and villous atrophy can persist even this far out in some people. I can't find any study that looks for recovery of villi any earlier than 6 months time.

Yet, I know... the recommendation is to eat gluten right up until the biopsy... despite the fact I'm coming up short on anything to support that.

Well, at least I found the recommendation from an authoritave source:

University of Chicago Celiac Center

Are you scheduled for a biopsy? Are you eating gluten?
Any changes in your diet can affect the accuracy of your biopsy results. It is necessary for you to be eating gluten every day for at least 4-8 weeks before the procedure. If you are scheduled for a biopsy and are not eating gluten, talk to your doctor about what is necessary to obtain accurate results. If you have a biopsy and have eaten gluten only a short time before the test, you and your physician will not know if a negative test result is accurate or due to your diet.
http://www.uchospitals.edu/pdf/uch_014187.pdf

[jccgf]

Sorry about the multiple posts, but I can't seem to be able to edit my posts to add more info because the text jumps around on me when editing.

University of Maryland Celiac Center

Are the villi permanently damaged in a patient with Celiac Disease and how long does it take for the villi to return to normal?
The villi are not permanently damaged. The intestine is an organ, which renews itself every three days. Therefore, if the damage is exclusively due to CD, the villi will be reformed once on a gluten-free diet. The time for the villa to return to normal varies among individuals.
http://www.celiaccenter.org/celiac/faq.asp#villi

that's pretty vague

Columbia University Celiac Center

A gluten-free diet should not be started until all diagnostic tests are completed, as the withdrawal of gluten can change test results. The recommendation by physicians, nutritionists, naturopaths and osteopaths to try a gluten-free diet as a trial of therapy for gastrointestinal symptoms, without biopsy confirmation of the diagnosis, should be discouraged.
http://www.celiacdiseasecenter.colum...ts/A02-FAQ.htm

[Curious]

Cara, switch your editing mode to wysiwg...it helps with that when editing.

[jccgf]

Originally Posted by Curious

Cara, switch your editing mode to wysiwg...it helps with that when editing.

Thanks, I'll try that...

[JohnDory]

Ok thanks for the links, you've convinced me! Pasta for lunch today then.

I was actually gluten-free a couple of weeks before the bloods, I told my doc this and he didn't seem too worried, so maybe thats why the other tests were negative. Been gluten-free around 5-6 weeks now.

Not sure when the biopsy is, am waiting for the letter, where i come from these things normally take a while so prob get my 4 weeks of gluten in before then. I am really keen to sort out my brain fog asap (writing my thesis at mo and am a long way behind schedual), so that's why i was reluctant to do anything that might set my progress back a couple of months.

[jccgf]

It stinks to have to go back on the poison ... but you'd hate to waste a good biopsy with questionable results. And, yes, as far as blood tests... 3-4 weeks COULD make a difference. The data on that is pretty clear. The doctors should know about this... but it is a common pitfall.

Of the various antibodies relating to gs/cd... I've heard the antigliadin IgG antibodies are the earliest to show up and the last to go away...so that just might make sense that that is all you were left with. You are lucky that your doctor included the antiglidian antibodies in the test panel. I'll give him that much. Too many doctors are excluding them, and yet... sometimes, plenty of times, they are the only antibody present.

It will be interesting to see if you notice any changes when you put gluten back in your diet. Sometimes people who really didn't think they were symptomatic... become symptomatic when 'challenging'. Other times... not!

[JohnDory]

I've been back on gluten for about a week now, and the first few days I had zero symptoms and was thinking the whole gluten sensitivity doesn't apply to me..

But after about day 3 I started really noticing changes. Even upset stomach which i hadn't really noticed before. Stools have changed a lot. Feel sick after eating bread.

It may be a few months before my biopsy and am in a point in my studies where i can't afford to feel ill, so am going to avoid gluten untill atleast I get notice of my biopsy

[lsocher]

Gluten sensitivity could lead to Celiac, which often results in b12 deficiency. **
I have been following a gluten-free diet for some time now, and I've never felt better.

LS.

Originally Posted by JohnDory

I've been back on gluten for about a week now, and the first few days I had zero symptoms and was thinking the whole gluten sensitivity doesn't apply to me..

But after about day 3 I started really noticing changes. Even upset stomach which i hadn't really noticed before. Stools have changed a lot. Feel sick after eating bread.

It may be a few months before my biopsy and am in a point in my studies where i can't afford to feel ill, so am going to avoid gluten untill atleast I get notice of my biopsy