Celiac Sprue questions

[Prairiewind]

Hello, I am a 30 year old woman with a strong family history of Celiac disease (Mother and two sisters have it, confirmed by biopsy) I recently went to a GI to be tested for Celiacs because I have been having symptoms such as abdominal pain and bloating (lifelong), diarrhea, intense skin itching, headaches, mouth sores, numbness and tingling in my hands and feet with a mild loss of coordination in my hands and muscle and joint pains. Sometimes I even feel like I have the flu. I tested positive for Anti-Gliadin antibodies and was told I indeed have Celiacs. I then had an EGD done and was told that there was no evidence of Celiacs (damage to my villi). They did find "Gastritis" and a Hiatal Hernia. I am now confused about whether or not I have Celiacs without a positive Biopsy result. I have seen the pictures of my "Gastritis", so what would be causing these nasty looking red patches in my intestinal tract if not Celiac disease? Is it common to miss Celiac damage on an EGD?
My second question is about the Hiatal Hernia, I am told that it causes no problems, but I recently got a nasty GI bug and everytime I had to vomit I could not. My stomach was full but everytime I wretched I could not get anything out and had horrible stomach pain. After about my fourth attempt at vomiting I finally was able to get it up. It just felt "stuck". I am assuming this is from the Hernia, is this a good reason to have the Hernia evaluated again by my GI?

Thanks so much!!

[Kevin Pho, MD]

Normally the antibody testing would be a pretty specific test for Celiac disease.  In cases where there is a family history or there is a high probability, more definitive testing with a small bowel biopsy (obtained during EGD) would have to be done.  

That being said, there is a possibility that the diagnosis may be missed during biopsy, and that several attempts or samples would have to be obtained.  

If there is still concern about the disease, you may want to consider repeating the EGD and biopsy for a more definitive approach.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
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