Can a biopsy for Celiac Disease come back positive but the blood work negative?

3 Comments

1. Laura U says:

   November 27, 2009 at 1:00 am

   Celiac Disease Gluten

   In testing for Celiac, bloodwork is usually done first. Then, if it comes back positive, a biopsy is done to confirm this. However, bloodwork is not always 100% accurate. Therefore, it is possible for the bloodwork to be negative, and the biopsy positive. Doctors know this. That is why a biopsy is usually done just to double check. Really, a biopsy is the most accurate way in detecting it. They check to see whether the microvilli in the lining of your small intestine have been damaged or appear to be smoothed out. This indicates that there has been damage caused by an autoimmune response against the gluten. Damage to the lining can cause malabsorption of nutrients. This is very serious. A gluten-free diet is the only way to repair this damage. If they did a biopsy and it was positive, indicating intestinal damage, I would say that you do have Celiac and should follow the diet required. A gluten-free diet can reverse much of the damage done. It may just take time for your body to adjust to a drastic diet change. Often, when people abruptly change their eating habits, there can be discomfort. It may take time for you to adjust. However, if you continue to eat gluten products and further damage your intestines, you may reach a point where the damage is irreversible. This kind of damage greatly increased your chances of developing malignancies in your small intestine.
2. Nah Z says:

   November 28, 2009 at 12:50 pm

   Celiac Diet

   By resuming a ‘normal diet’ you have knowingly and willingly quite literally continued burning your digestive system.

   The biopsy is as conclusive a diagnosis of celiac as it gets. You ‘got sick’ because you took a major food group out of your diet- it takes months to see the positive effects of removing gluten.

   You absolutely need to go on a gluten free diet again straight away, this time understanding the reality that it is for life.
3. kureyon says:

   November 28, 2009 at 6:50 pm

   Celiac Diet

   I would tend to trust the biopsy rather than the blood test - you can have false negatives with the blood test for various reasons, it’s isn’t completely reliable. They usually test for a particular type of antibody, but not everyone with coeliac disease has that antibody. Whereas with the biopsy, the effect on the intestine can be really clearly seen by eye. It’s a lot more conclusive. But you should go back and ask your doctor to explain it a bit more if you’re not sure or if you don’t feel well.