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Has Anyone Heard Of This Test?


GEF

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GEF Explorer

I know it sounds horrible, but I read about this in the book, Dangerous Grains. It's called the rectal challenge (RGC). This is my understanding of the test: gluten is applied to an area of your colon (probably by way of a sigmoidoscopy), within a few hours or so, the doctor then removes the spot where he/she applied the gluten via biopsy and that specimen is examined for damage.

This test apparently removes the chances that the damaged areas in our upper intestines are missed during the conventional endoscopy method. Also supposed to be good for those who are pregnant, children and those already on the gluten-free diet. But, this must be done by a physician that is familiar with the various stages of damage.

Anyone had this done?

Gretchen

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GEF Explorer

I have a (NEW) doctor's appointment on 10/8... this time with a celiac specialist. I'm going to ask for this test. I'll let you know what I find out, but it might be a few months. I'd opt for this over the endoscopy anyday!! Especially for more accurate results!!

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gf4life Enthusiast

I would be interested in knowing how the doctor responds and if you are able to get the test done. I have read about the test, but as far as I know it is not commonly done. In my opinion, it should be done more often, since it seems to be easier to do than the biopsy and less risky as far as getting a false negative result.

God bless,

Mariann

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Alexolua Explorer
I'd opt for this over the endoscopy anyday!!

But for this one, won't you have to drink that awful stuff to clear you out? And things aren't suppose to go up that way! Sounds uncomfortable too.

Does sound like a good test though to have done though. Especially with the drawbacks of the endoscopy. Could try mentioning it to my GI doc when I see him this week, but if it's uncommon, I doubt he'll have heard of it. He still thinks neg biopsy = no celiac, lol.

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rattaway Newbie

a negative biopsy doesn't mean no celiac? I know I sound a bit simple since I have been posting on here for a couple of months, but I haven't heard of too many neg. biopsies equaling celiac or did I miss that? My mom was diagnosed with diverticolitis and shows all the signs of celiac but since she had a biopsy that was neg., she decided she can't possibly be gluten intolerant. I am curious as to how many neg. biopsy people have found that they still do better on a gluten-free diet. Gretchen, please let us know how the test goes. BTW, you two make a beautiful couple. Thanks for all the great info :D , Rian

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txceliacmom Newbie

My daughter had a negative biospy and negative panel results. After an additional month of stomach pain we put her on a gluten free diet and within weeks she was better. She's been gluten-free since last october and is good unless we have a slip up.

Biospies are not always accurate because sometimes the damage is spotty. If they don't take the samples where the damage is, it will come up negative. Also, depends on how good the lab is.

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Alexolua Explorer
a negative biopsy doesn't mean no celiac?

All a biopsy can tell is if the small intestines is damaged. A gluten intolerance doesn't always damage the small intestines right away, but can cause other problems instead. And there are the problems txceliacmom mentioned about the test too.

Pretty sure there are a few others here at the least, who had neg biopsies too.

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gf4life Enthusiast

I had a negative biopsy. I don't know if it was the fact that I had been gluten-free previously, and had not been back on gluten long enough to cause enough damage, or if the doctor didn't take samples from the right area, or if the lab wasn't skilled enough to recognise the early stages of damage, but what ever the cause of the negative biopsy I an so sick when eating gluten and so much better when I am gluten free. I already had done the Enterolab tests before I did convince my doctor to do a biopsy, and already knew I carry the gene and am producing positive levels of antibodies. I just thought it might be nice to have a doctors diagnosis. I don't have that, but will remain gluten free for life.

God bless,

Mariann

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judy04 Rookie

Hi,

I also had a neg biopsy, no villi damage, but gluten makes me

extremely ill. It has taken almost 9 months and I am no longer sick

and have no pain. I also tested Neg for the gene!

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judy04 Rookie

Hi,

I also had a neg biopsy, no villi damage, but gluten makes me

extremely ill. It has taken almost 9 months and I am no longer sick

and have no pain. I also tested Neg for the gene!

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GEF Explorer

Here's some more info on the test:

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A slurry of gluten powder in physiological saline was introduced into the rectum, and biopsies taken before and at 2 h or 4 h after the challenge were examined immunohistochemically by computerized image analysis. Cell counts were analysed by logistic regression, and the best equations were obtained for each challenge group. The 2 h challenge yielded diagnostic sensitivity and specificity of 69.6% and 78.6% respectively. The 4 h challenge provided sensitivity and specificity of 100% and 100% respectively. These results were compared with other clinical diagnostic predictors, including anti-endomysial antibodies, which yielded diagnostic sensitivity and specificity of 70% and 98% respectively. It is concluded that a 4 h rectal challenge is a highly sensitive means of identifying gluten-sensitized individuals, and would be of particular value in cases showing negative antibody screening or equivocal biopsy appearances.

Gretchen

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