A new study has found that most patients undergoing biopsy of the small intestine do not have the recommended number of samples to diagnose celiac disease. The study, published in the July 2011 issue of Gastrointestinal Endoscopy, analyzed a national database of biopsy specimens. More than 100,000 patients had a biopsy of the small intestine, but only 35 percent of them had at least four samples taken, the number recommended by professional guidelines.
Because celiac disease can affect the small intestine in a patchy distribution, just one or two biopsy samples could potentially miss the evidence of the disease. The investigators identified 132,352 individuals who underwent biopsy between 2006 and 2009, for a variety of medical indications, including diarrhea, abdominal pain, esophageal reflux, and anemia. Only 35 percent of this group had at least four specimens submitted, and the most common number of specimens submitted was two. But adhering to the recommendation of submitting at least four specimens more than doubled the diagnosis rate of celiac disease.
Even when physicians indicated that they were suspicious of celiac disease (e.g., when patients had positive celiac disease blood tests), fewer than 40 percent of patients had at least four specimens submitted; the diagnosis was increased sevenfold when the guidelines were followed. The process of increasing the number of specimens from two to four takes approximately one extra minute during endoscopy.
Tuesday, July 26, 2011
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3 comments:
Bonnie, my gluten intolerance has gotten worse this last year. I've gone totally gf....I've lost 24 pounds since December, 10. I'm due for an endoscopy in Feb...I was told that my biopsy in 09 was negative... bloodwork last year was also negative. Is it true that if you are gluten free then blood work won't be valid?
Please email Bonnie directly if you are a client so she can take into account your individual needs.
I have celiac disease, and I know that if you are gluten free and have a biopsy, the damage will not be shown. My gastroenterologist required me to eat gluten for a month first before I could be diagnosed. Not sure if this is helpful or not.
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