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

Joel Elias <[log in to unmask]> wrote:

>For the last six months or so, I had been suffering from
>indigestion....I....found a link to Scott Adams' WWW site on
>Celiac.  Based on what I learned there, I started a gluten-free
>diet....After two days, I feel great.
>
>I plan to contact the specialist on Monday to ask for a
>sigmoidoscopy and biopsy for Celiac.
>
>Should I also request a blood test?

I'd leave that up to the specialist.  He may feel your symptoms
and subsequent reaction to a GF diet are good enough to go ahead
with a biopsy.  If not, then he may want (and I'd push for) the
celiac antibody blood tests.

>Presumably, it will take about a week or so to schedule the test,
>so that if I were to continue the gluten free diet, I would have
>been on it for about two weeks before the biopsy. Is this too long?
>Should I revert to my normal diet before the biopsy/blood test?

If you can handle the normal diet again for awhile, and if you want
a firm diagnosis, I'd say it is best to eat gluten up to the day of
the biopsy.  Otherwise, if the damage is not too severe you may heal
enough in the two weeks to mess up the diagnosis.  (This is the
opinion of another lay person, BTW.)

Several people have discussed on the list how they or their chidren
went on a GF diet without a biopsy-confirmed diagnosis.  They were
convinced by their recovery or lessening of symptoms that they had
celiac disease, and didn't feel an "official" biopsy-confirmed
diagnosis was required.  This is a personal choice, of course.
Certainly, if you've been GF for a long time, and dread the prospect
of putting yourself or your child through a long-term gluten
challenge, you may choose to have the diagnosis remain "unofficial".
However, I think a biopsy-confirmed diagnosis has some benefits:

1. It allows you to claim the extra costs of GF foods as part of a
   medical deduction on your taxes (in the USA).  This is only of
   value if you have a LOT of medical expenses paid out of your
   pocket.

2. It eliminates (or at least greatly reduces) the possibility of
   your symptoms having been caused by some other problem and just
   coincidentally improving on a GF diet.

3. For children especially, an official diagnosis that you can "point
   to" can help you to convince your children not to cheat on the
   diet when they get to those wonderful, rebellious teenage years.

4. If you are hospitalized or need medications for other problems,
   you made need proof of your celiac condition to get a special diet
   or avoid generic equivalents when getting prescription drugs.
   Having an official diagnosis in your files may be of great help in
   convincing your doctor, the hospital, or your insurance company
   that you aren't just being picky or unreasonable in demanding GF
   food and medications.

If you agree that an official diagnosis is beneficial, and have only
just started a GF diet, then I think it makes a lot of sense to go
back to eating gluten until after the biopsy.  For those that have
been GF a long time but were never biopsied, going back on gluten is
not nearly so easy a decision: It will take a long time to get back
to the state where a biopsy would be conclusive and during that
time your symptoms will probably return.  Still, I think it is worth
considering.

Not medical advice; just the prattlings of a lay person.

Jim Lyles ........ <[log in to unmask]> ........ Holly, Michigan, USA