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Celiacs Diagnosis

My 10 year old and 7 year old diabetic daughters recently tested positive for possible
celiacs disease on bloodwork. There doc referrred them to a GI to have a biopsy done
for definitive diagnosis. I contacted the GI's office to inquire as to whether or not I needed
to start them on a gluten free diet. Well, they told me that they did not need to be seen
because the bloodwork was all I needed to get a diagnosis. I've read in multiple locations that
a biopsy is required to make a diagnosis, but they keep telling me its not. I also read that
there is a difference between celiacs and gluten intolerance, but the GI told me there wasnt.
Is this Doc right, or do I need to look for another GI. Please Help!!!
Best Answer
231441 tn?1333892766
COMMUNITY LEADER
Hello,

Biopsy is only necessary if the blood tests are negative - in your daughters' cases the tests were positive.  The reason for biopsy is that the blood tests have a high rate of false negative - but if the blood tests are positive that can also be quite conclusive.   I am assuming they also have symptoms which prompted the testing.

Biopsy is quite invasive and not something you want to do to your children unnecessarily.

My daughter had every symptoms in the book but negative blood work.  We did gluten free diet as part of an elimination diet with remarkable recovery (found out she is sensitive to gluten and dairy).  The GI doctor and I agreed that the response to diet was already conclusive enough and we didn't want to challenge a 2 1/2 yo with gluten for a few months prior to biopsy (she was so sick and it was affecting her growth and development!) and we just accept the diagnosis as a long-term one.

Celiac and gluten intollerance both mean that you should avoid gluten.  Some say that people with gluten intollerance can have trace amounts of gluten and that with celiac should avoid completely.

However, the blood testing has effectively diagnosed celiac, so I'd say it should be conclusive enough.
4 Responses
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231441 tn?1333892766
COMMUNITY LEADER
Ah, considering their problems the celiac diagnosis seems even more likely.  Celiac seems to be more common in combination with thyroid and diabetes (all autoimmune).    I have all three too.  My daughter only celiac so far and I really hope that managing itt will help prevent other complications for her.

Have you read Richard Bernstein's Diabetes Solutions? You can google it.  It may be beneficial in terms of diet (and it's congruent with celiac - he uses a strict low carb approach, including for children.

Gluten free diet can be very healthy, if you stick to basic and unprocessed foods.  I have also started baking with things like coconut and almond flours for occassional treats.

Best wiehs.
Helpful - 0
Avatar universal
Thank you, your response was very helpful. I really appreciate any advice I can get. My only issue was that I hate to treat them for something that they may not have, but I guess I need to accept that they have celiacs and just deal with it now. It's really nothing I cant handle I suppose. They already have diabetes, hypothyroidism, and a kidney disease. Atleast all celiacs disease is, is a gluten free diet which will make them healthier anyway. Again, thank you for your advice.
Helpful - 0
1711789 tn?1361308007
MEDICAL PROFESSIONAL
Hi there!

Coeliac disease is a form of gluten intolerance and both are the same for clinical purposes. A diagnosis can be based on serology/ blood tests alone, though this may be followed by a biopsy for confirmation. With a negative serological/ blood tests, biopsy is only indicated if the clinical suspicion remains very high.
Hope this information is helpful.

Take care!
Helpful - 0
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