Is an Endoscopy Necessary for a Celiac Diagnosis?

If you may have celiac disease, you’re probably asking yourself, “is an endoscopy necessary?”
An endoscopy is an examination of the small intestine for villi, and will often include a biopsy (small tissue sample) of the intestine. Villi are small “hairs” lining the intestine, that help to digest and absorb nutrients. In an individual with celiac disease, these villi are attacked by the same antibody, tTg, created to fight gluten. This causes (usually repairable) damage. The endoscopy will usually involve fasting for 12 hours, an hour under anesthetic (read: asleep), and some recovery time. Patients may feel groggy after the endoscopy, but will usually feel back to normal within 24 hours. Of course, you should not drive yourself to or from an endoscopy!

Your doctor should recommend an endoscopy, either before or after a blood test, as part of your celiac diagnosis. The blood test will measure your antibody levels; the endoscopy will give an idea of how much damage has been done. If you don’t have celiac disease, it may also catch other, similar health issues that are causing celiac-like symptoms.
After your gut’s had a chance to heal (usually after six months on a gluten free diet), your doctor may recommend another blood test and/or endoscopy, to verify that the antibody levels are down and that your villi are healing. If your symptoms are gone and you feel in good health, just the blood test may be adequate.

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