<<Disclaimer: Verify this information before applying it to your situation.>>

Hi,

>My youngest brother expected to be celiac, but the biopsy was
>negative.  How reliable is a negative biopsy?  And if we don't
>believe the result of the biopsy, why have one?

Well, a biopsy confirms that your autoimmune system is attacking your
intestinal wall, blunting and flattening the villi. Sometimes, they can take
a biopsy, when the villous damage is patchy, from a healthier part, and it
looks normal. Or, the pathologist will not diagnose celiac because he/she
requires totally flat villi, and subsequent recovery on the diet, to make
the diagnosis.

But what about gluten sensitivity. Now, you can call me dumb, but I think
that when a person's immune system is mounting a response to a food they are
eating, then that is not a good thing. Most such cases of gluten sensitivity
cannot, by current standards, be diagnosed as celiac disease. So, you can
have some very sick people, who cannot be given a medical label because
their illness isn't bad enough yet. Heck, maybe it never will be. The
literature indicates that about 5% of a relatively small group (2,000 I
think) of healthy U.S. blood donors showed antibodies against gliadins. A
random study in Iceland showed 15% of the population had anti-gliadin
antibodies.

If I took my car to a mechanic, and the engine was still running, with a
quart and a half of oil in the crankcase, and he told me that he couldn't do
anything until it seized up, or blew up, and then he could rebuild the
engine for me, I would report him to the police.

But somehow, we have significant numbers of folks who are getting ill from
what they are eating, but until they get really sick, no diagnosis is rendered.

Sadly, I'm at risk of offending the members of the medical profession who
are working very hard to remedy that situation, because they are the doctors
who are on this list. I appologize in advance, because that is not my intent.

I think the biopsy is a good, quite reliable indicator of celiac disease.
But it leaves about 14.5% of the population sick, and unable to help
themselves because sometimes, definitions are more important than peoples'
health.

I would also like to suggest that you go to a library, and order this
article through interlibrary loan, or document delivery, if you can't find
it in the library:

Troncone R, Greco L, Mayer M, Mazzarella G, Maiuri L, Congia M, Frau F,
deVirgilis S, Auricchio S, "In Siblings of Celiac Children, Rectal Gluten
Challenge Reveals Gluten Sensitization Not Restricted to Celiac HLA"
_Gastroenterology_ 1996; 111: 318-324

Best Wishes,

Ron Hoggan   Calgary, Alberta, Canada