<<Disclaimer: Verify this information before applying it to your situation.>> Dana wrote, I'm new to the list and just read the FAQ but still have a couple questions. In obtaining the biopsy to diagnose Celiac Disease, how is this done? The FAQ stated that children sometimes need to be sedated. I can't picture how this is done to the small intestine without sedation - for adults too. The following is a procedure note on how a Gastroscopy - (gastric biopsies) is done. The patient was fasted overnight. She was premedicated with Demerol 75 mg, Gravol 50 mg, and Atropine 0.6 mg intramuscularly 30 minutes preop. She was brought to the Operating Room Suite and was administered topical Xylocaine and IV propofol. Excellent sedation was achieved and the Olypmus gastrovideoscope easily introduced into the esophagus; no abnormality of the upper midesophagus. GE junction is located at 37 cm from the incisors. There was active reflux with pearly discoloration of the mucosa and streaks of erythema just at the GE junction. Evidence of GE reflux esophagitis. There were no actual ulcers, stricture or organic narrowing that might explain her dysphagia per se, but reflux with esophageal spasm certainly could be occurring independent of this examination. Good visualization was obtained of the body and antrum. The pylorus itself was concentric and the endoscope advanced to the first and second part fo the duodenum in which there was active duodenitis with friability +1 and some erythema present even before I advanced the scope into the duodenum. There was no actual ulcer per se. Markings were rather prominent here. Biopsies were taken to look for Helicobacter pylori. The scope was retroflexed to view the fundus which was unremarkable apart from the obvious incompetence of the GE sphincter. I then directed attention to the GE junction of the esophageal side thereof. Picture was taken for the permanent record and biopsies were obtained. The remainder of the esophagus was very carefully inspected on withdrawal, and a thorough examination revealed absolutely no significant pathology otherwise. There is no abnormality of the hypopharynx that I could visualize either and the patient tolerated the procedure well and returned to the PAR in good condition. If anyone needs any more explicits details or has direct question related to biopsies, please let me know and I will ask on of the gastroenterologist's at work. Dorothy Hilde Salmo, British Columbia Canada