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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]
Overview
Endoscopy may be helpful in the diagnosis of celiac disease especially when the biopsies of luminal wall are obtained for microscopic evaluation. Most patients with celiac disease have a small bowel that appears normal on endoscopy; however the following findings are more suggestive of celiac disease: Scalloping of the small bowel folds, paucity in the folds, mosaic pattern of the mucosa, prominence of the submucosal blood vessels, and Nodular pattern to the mucosa.
Other Diagnostic Studies
Endoscopy
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Endoscopy may be helpful in the diagnosis of celiac disease specially when the biopsies of luminal wall are obtained for microscopic evaluation. An upper endoscopy with biopsy of the duodenum (beyond the duodenal bulb) or jejunum should be performed. Multiple samples should be obtained (four to eight) from the duodenum. As celiac disease has a sparing feature, not all areas may be equally affected. Thus if biopsies are taken from healthy bowel, it would result in false negative results.
Most patients with celiac disease have a small bowel that appears normal on endoscopy; however the following findings are more suggestive of celiac disease:[1]
- Scalloping of the small bowel folds
- Paucity in the folds
- Mosaic pattern to the mucosa
- Described as a cracked-mud appearance
- Prominence of the submucosal blood vessels
- Nodular pattern to the mucosa
Fiberoptic endoscopy carries a higher sensitivity rate than historical methods like Watson capsule. In the Watson capsule method, biopsies were obtained using metal capsules attached to a suction device. The capsule was swallowed and allowed to pass into the small intestine. After X-ray verification of its position, suction was applied to collect part of the intestinal wall inside the capsule.[2]
References
- ↑ Niveloni S, Fiorini A, Dezi R, Pedreira S, Smecuol E, Vazquez H, Cabanne A, Boerr LA, Valero J, Kogan Z, Maurino E, Bai JC. (1998). "Usefulness of videoduodenoscopy and vital dye staining as indicators of mucosal atrophy of celiac disease: assessment of interobserver agreement". Gastrointestinal Endoscopy. 47 (3): 223–229. PMID 9580349.
- ↑ Mee A, Burke M, Vallon A, Newman J, Cotton P (1985). "Small bowel biopsy for malabsorption: comparison of the diagnostic adequacy of endoscopic forceps and capsule biopsy specimens". Br Med J (Clin Res Ed). 291 (6498): 769–72. PMID 3929934.