Can I have gluten sensitivity if small intestinal biopsies are normal or only minimally abnormal?
Although by definition a normal small bowel biopsy rules out celiac sprue, it does not rule out gluten sensitivity. Although asymptomatic people with gluten sensitivity may have normal or near-normal biopsies, so too may people with symptomatic gluten sensitivity. This has been reported in the medical literature (called “Gluten Sensitivity with minimal Enteropathy” or “Gluten-Sensitive Diarrhea without Celiac Disease”. Furthermore, even though such people’s intestines appear normal under the microscope, up to one half already have nutrient malabsorption, a major contributor to osteoporosis and malnutrition, attesting to the fact that microscopic analysis of intestinal biopsies is an insensitive way of assessing function and immunologic food sensitivity.
