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Diagnosis help


Kaatzal
Go to solution Solved by trents,

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Kaatzal Newbie


I am getting very confused with the process of getting a diagnosis of potentially coeliac disease.

I have been having all of the symptoms associated with coeliac disease so I cut out gluten and saw an improvement. I have visited a gastroenterologist and he tested me for genes that might lead to coeliac disease. I have tested positive for one of these genes (he hasn’t specified which). 

I had a blood test and to check for coeliac disease and it tested negative but I had stopped eating gluten for a few weeks before this test. So this test was ruled unreliable.

However, a few years ago I was tested for coeliac disease whilst I was eating gluten (had no symptoms at this time) and the test was negative. Due to the result of this test, the gastroenterologist is saying that I definitely do not have coeliac disease as he believes it would have tested positive even though I wasn’t having symptoms. 

I have been reading papers and information on the Coeliac U.K. website and it says that Coeliac disease can be developed at any time. This seems to be contradicting information.

Any help would be greatly appreciated


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plumbago Experienced

The only way to reliably know if you have active disease is to go back to eating gluten, wait, and then repeat the comprehensive celiac panel.

From NHS Inform:

Before a blood test is taken, it's important that you eat gluten-containing foods in more than one meal every day for at least 6 weeks before the test. Remember to eat a normal gluten diet for 6 weeks before any tests.

Wheatwacked Veteran
18 minutes ago, Kaatzal said:

the gastroenterologist is saying that I definitely do not have coeliac disease as he believes it would have tested positive even though I wasn’t having symptoms. 

He is wrong.  It is not uncommon for it to take 10 or more years to be diagnosed with misdiagnoses of other diseases along the way.

"To make matters more challenging, celiac symptoms can also mimic symptoms of other diseases, such as anemia, Crohns disease, gastric ulcers, irritable bowel, parasitic infection, even various skin disorders or nervous conditions."

 

  • Solution
trents Grand Master

The onset of celiac disease can happen at any stage of life. Before onset you will possess the genetic potential but all other tests will be negative.

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    • Scott Adams
      This is a very common question, and the most important thing to know is that no, Guinness is not considered safe for individuals with coeliac disease. While it's fascinating to hear anecdotes from other coeliacs who can drink it without immediate issues, this is a risky exception rather than the rule. The core issue is that Guinness is brewed from barley, which contains gluten, and the standard brewing process does not remove the gluten protein to a level safe for coeliacs (below 20ppm). For someone like you who experiences dermatitis herpetiformis, the reaction is particularly significant. DH is triggered by gluten ingestion, even without immediate gastrointestinal symptoms. So, while you may not feel an instant stomach upset, drinking a gluten-containing beer like Guinness could very well provoke a flare-up of your skin condition days later. It would be a gamble with a potentially uncomfortable and long-lasting consequence. Fortunately, there are excellent, certified gluten-free stouts available now that can provide a safe and satisfying alternative without the risk.
    • MogwaiStripe
      Interestingly, this thought occurred to me last night. I did find that there are studies investigating whether vitamin D deficiency can actually trigger celiac disease.  Source: National Institutes of Health https://pmc.ncbi.nlm.nih.gov/articles/PMC7231074/ 
    • Butch68
      Before being diagnosed coeliac I used to love Guinness. Being made from barley it should be something a coeliac shouldn’t drink. But taking to another coeliac and they can drink it with no ill effects and have heard of others who can drink it too.  is this everyone’s experience?  Can I drink it?  I get dermatitis herpetiformis and don’t get instant reactions to gluten so can’t try it to see for myself. 
    • trents
      NCGS does not cause damage to the small bowel villi so, if indeed you were not skimping on gluten when you had the antibody blood testing done, it is likely you have celiac disease.
    • Scott Adams
      I will assume you did the gluten challenge properly and were eating a lot of gluten daily for 6-8 weeks before your test, but if not, that could be the issue. You can still have celiac disease with negative blood test results, although it's not as common:  Clinical and genetic profile of patients with seronegative coeliac disease: the natural history and response to gluten-free diet: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606118/  Seronegative Celiac Disease - A Challenging Case: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9441776/  Enteropathies with villous atrophy but negative coeliac serology in adults: current issues: https://pubmed.ncbi.nlm.nih.gov/34764141/  Approximately 10x more people have non-celiac gluten sensitivity than have celiac disease, but there isn’t yet a test for NCGS. If your symptoms go away on a gluten-free diet it would likely signal NCGS.
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