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"What is an endoscopy?"


Do I definitely have to get an endoscopy if Celiac disease is suspected, or is there another way for me to get a conclusively diagnosis? To be honest, the thought of an endoscopy makes me queasy and I'd like to avoid it.


First, let me describe what exactly an endoscopy is and then I’ll describe the diagnosis of Crohn’s disease (CD). Endoscopy is a general term, but more specifically a colonoscopy is a procedure that allows physicians to evaluate the large intestine and some of the small intestine. Prior to the procedure a patient has to undergo a colon prep which involves certain dietary restrictions and the consumption of a laxative that cleanses the colon of stool to improve visualization of the intestinal lining.

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During the procedure you will lie on his or her side or back and a thin, flexible tube with a camera on it is inserted into the anus and advanced through the rectum and into the colon. Sometimes doctors will sometimes provide a light sedative to help make the procedure more comfortable. The tube and camera are then advanced while the doctors evaluate any concerning lesions and take small biopsies. The procedure can last anywhere from 15 minutes to an hour. The diagnosis of CD is primarily requires both typical symptoms of Crohn’s and biopsies from an endoscopy that demonstrate characteristic features. The diagnosis, however, can also be made based in the appropriate setting based on your medical history and findings from other abdominal imaging studies such as a series of x-rays with oral contrast known as a small bowel follow-through. Other imaging such as MRI can also be helpful. Finally, blood tests for proteins that are made against one’s own body, called autoantibodies can also be helpful, but there is not yet a consensus on their most appropriate use in the diagnosis of CD. It is likely given the seriousness of the disease and the consequences of treatment that your doctors will want to be as sure as possible of your diagnosis, and so a colonoscopy is likely in store. You should talk with your primary care physician or a gastroenterologist to further discuss the risks and benefits of the different options.

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