Endoscopy

An endoscopy with multiple biopsies is the only way to have a 100% accurate diagnosis of celiac disease. Maybe one day they will find blood work that is accurate enough not to do the endoscopy but right now that is not the case. The biopsies are sent to a pathologist to assess if there is any damage to the villi in the small intestine. It is important to continue eating gluten until the endoscopy is preformed. The body is a miraculous thing and begins to heal immediately. Patients, especially children, who are diagnosed soon after onset of celiac disease can heal rapidly causing the biopsies to come back negative for damage and thus negative for celiac disease. So continue to eat gluten until all diagnostic measures are taken.

It used to be that a second endoscopy was preformed 18 months after starting a gluten-free diet to ensure that the intestines were healing. However, that is not the common practice anymore, though some doctors still do it. If patients are improving on a gluten-free diet and their antibody levels are decreasing the doctors don't find it necessary to go back in again.

I will admit, the endoscopy was not a fun experience. Did you know that if you are an adult they think you are mature enough not to be completely put under? Well obviously they didn't take into account me. I can handle a lot of things, but there are three things that I really don't like; needles, people in my mouth (my poor dentist), and throwing up. This, in a way, combined all three things. (I didn't throw up, but did gag when they pulled the tube back up which is just as bad as throwing up) I'll just say, the nurses were not amused with me. Granted, the 'mild sedative' did take the edge off and made me loopy enough to comply to their instructions I otherwise would have put up a fight against, like "open your mouth". In the end I survived, and I guess if I really had to do it again I could. But only if I REALLY have to. When my doctor came in to start the procedure she said: "Usually I can't tell anything by just looking, unless there is severe damage, beyond the damage to your villi; we usually have to wait for the pathologist report to come back. So, after this you can go and eat all the Krispy Kreme donuts you want." I politely told her that I didn't care if she could or couldn't tell anything just by looking, I was starting to eat gluten-free that day because I was tired of being sick. Well, when she finally got down into my small intestine I heard her say, through my mildly sedated haze, "Wow, you definitely have it! No more Krispy Kremes for you." Ha! I told you so. So in the end, she told me no more gluten, gave me some souvenir pictures of my intestines, and sent me on my way. When the pathologist report came back it said the same thing only in greater detail. "Near complete obliteration of the villi; Chronic inflammation of the intestine" and a lot of other stuff that I didn't fully understand, but it's not good. But as I said earlier, the body is a miraculous thing. It can heal itself even from extensive damage. So as long as I stay away from gluten I will completely heal. It just may take a few years. But I don't mind because if 15+ years of damage can be healed in 2 years, I'm not complaining.