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Suspect Celiac, But Tests Suggest Otherwise


erinb24

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erinb24 Newbie

I've had symptoms going on for a while now, and I have been suspecting celiac. I've been seeing a GI whom I trust and I think is very competent. I know that he has had experience with seeing celiac disease, as he typically diagnoses 2-3 celiac patients a year. He suspected celiac due to my severe anemia, and after a negative blood test, did a colonoscopy and an endoscopy. I got some unofficial results today and the small bowel test came out clean. I'm very discouraged, because my symptoms lined up so well with celiac and I'm ready to find answers. I've had mild symptoms for the past few years, but it's gotten bad in the past year and a half and in the past few months has gotten almost unbearable. Here's a list of my symptoms:

really bad/extreme bloating (my stomach has gotten much larger since I started experiencing this)

anemia (hemoglobin was a 6.9 a month ago and my doctor ordered a blood transfusion)

IGA deficiency

had my gallbladder out in 11/07

headaches/dizziness

numbness in my fingers

periods of sudden weight loss and gain (been in a time of gain for a year and a half now, yuck)

acid reflux (Dr. put me on Nexium)

gas

fatigue

mild depression/possible brain fog

back pain

I have an appointment on December 22, and I'm anxious to find out what to do next. I'm wondering if he'll want me to try a gluten-free diet to see how I react. I've never gone gluten free, so I don't know what to expect. Could this still be celiac or is it something else? I'm just so ready to find answers so that I can feel normal again.


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ShayFL Enthusiast

The "small bowel" had nothing to do with Dx Celiac. It is the "upper" endoscopy that is important. Make sure you get COPIES of ALL of your labs/results. Post in here, so we can help you. Dx 2 - 3 patients a year does not make him an expert even though he might be a wonderful doctor. Doctors are human too and make mistakes. It is your health and you need to make sure. We can help!!

Did they do a complete Celiac blood panel on you? Results?

nora-n Rookie

The samlwel consists of three parts, the duodenum, where they look for celiac, and two more parts. some patients clearly have celiac somewhere else than the first part of the duodenum. I have also heard that some doctors only take one sample, and will most likely miss celiac that way.

I have heard of someone who paid for a video capsu endoscopy and it clearly showed celiac.

I have also read that some clinics do at least 12-15 samples for celiac since it is som patchy.

I have also read that some pathologists will not diagnose celiac when the villi are flattened.

Also, if you go to Dr. Scot Lewey's webpage on his blog he writes that early celiac one can only see increased IEL or what they are called, and that more than 2-3 on each villi tip is abnormal, but that doctors do not report that, nor thing it is abnormal with 5 or more....

One has to read the pathology report and everything.

Also, someone psoted recently that Dr. Greene added gliadin to a biopsy sample to seeif it reacted to gliadin (to differentiate from other possible things) and ot was clearly gliadin that caused an immune raction. It is easy to see immune reactions on tissue samples, they light up with a special technique, they get flourescent. That is how they diagnose DH, by the way.

If you keep getting negative results, you might have lyme disease, and it si very common for such patients to get very very similar symptoms to celiac. The glutens sensitivity from Lyme goes away after Lyme has been treated adequately they say, several here have reported that.

nora

erinb24 Newbie
The samlwel consists of three parts, the duodenum, where they look for celiac, and two more parts. some patients clearly have celiac somewhere else than the first part of the duodenum. I have also heard that some doctors only take one sample, and will most likely miss celiac that way.

I have heard of someone who paid for a video capsu endoscopy and it clearly showed celiac.

I have also read that some clinics do at least 12-15 samples for celiac since it is som patchy.

I have also read that some pathologists will not diagnose celiac when the villi are flattened.

Also, if you go to Dr. Scot Lewey's webpage on his blog he writes that early celiac one can only see increased IEL or what they are called, and that more than 2-3 on each villi tip is abnormal, but that doctors do not report that, nor thing it is abnormal with 5 or more....

One has to read the pathology report and everything.

Also, someone psoted recently that Dr. Greene added gliadin to a biopsy sample to seeif it reacted to gliadin (to differentiate from other possible things) and ot was clearly gliadin that caused an immune raction. It is easy to see immune reactions on tissue samples, they light up with a special technique, they get flourescent. That is how they diagnose DH, by the way.

If you keep getting negative results, you might have lyme disease, and it si very common for such patients to get very very similar symptoms to celiac. The glutens sensitivity from Lyme goes away after Lyme has been treated adequately they say, several here have reported that.

nora

Thank you for all your helpful advice. I will continue to post as I get through this. I had a blood test but it came out negative, but I know that the low IGA skewed those results. I don't know how many samples the doctor got, but I will ask when I have my next appointment. I just can't shake the feeling that it is celiac. I also don't know what else it could be, especially with the anemia and my hemoglobin being so low. I know that diagnosing 2-3 cases per year doesn't make an expert, but I feel that my doctor will help me find answers. I hope that when I talk to him next week I'll get a further into investigating these problems. I just talked to the nurse and she didn't have all the results, so who knows what will happen!

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    • trents
      I would ask the GI doc about the elevated IGA score of 401. That one is what we commonly refer to as "total IGA" and also known as "Immunoglobulin A (IgA)". It could be nothing but it can also indicate some other health issues, some of them serious in nature. I would google potential causes for that if I were you. Also, if there is a chance the GI doc will want to do more testing for celiac disease, either antibody testing or an endoscopy with biopsy, you should not cut back on gluten consumption until all celiac disease testing is done. Otherwise, you will invalidate the testing.
    • shell504
      Hello. I apologize. I didn't know there wasn't a standard.  The standard listed  for the IGA is normal range 47-310.  The others were all listed as <15.0 u/l is antibody not detected and 15> antibody is detected.  And the negative one the standard is negative.  It is a normal PCP dr. I do have a second opinion appt scheduled with a GI specialist in 2 weeks. Honestly, I haven't cut out gluten at all. I just switched to whole fibers and everything has been getting better. She wanted to do the test just to check, which I was fine with. We'll see what the GI dr says. Thank you for commenting. 
    • trents
      It is also possible that since eating the fries you have been glutened again during the week. I would double check the food in your cupboard and reread the ingredient lists. Food companies can and do change their formulations from time to time such that something that used to be gluten free is no more. What I am saying is, don't assume the distress you are experiencing comes from one incident of glutening. There could, coincidentally, be another one on it's heels. 
    • trents
      Welcome to the forum, @shell504! The IGA 401mg/dl is not a test for celiac disease per se but a check to see if you are IGA deficient. People who are IGA deficient will produce celiac blood test antibody scores that are artificially low which can result in false negatives for the individual antibody tests such as the TTG IGA. You did not include reference ranges along with the test scores and since each laboratory uses custom reference range scales, we cannot comment with certainty, but from the sheer magnitude of the IGA score (401) it does not look like you are IGA deficient. And since there are no annotations indicating that the other test scores are out of range, it does not appear there is any antibody evidence that you have celiac disease. So, I think you are warranted in questioning your physician's dx of celiac disease. And it is also true that a colonoscopy cannot be used to dx celiac disease. The endoscopy with biopsy of the small bowel is the appropriate procedure for diagnosing celiac disease. But unless there is a positive in the antibody testing, there is usually no justification for doing the endoscopy/biopsy. Is this physician a PCP or a GI doc? I think I would ask for a second opinion. It seems as though this physician is not very knowledgeable about celiac disease diagnositcs. Having said all that, it may be that you suffer from NCGS (Non Celiac Gluten Sensitivity) rather than celiac disease. The two gluten disorders share many of the same GI symptoms. The difference is that NCGS does not damage the villous lining of the small bowel as does celiac disease. NCGS is 10x more common than celiac disease. The antidote for both is complete abstinence from gluten. Some experts believe NCGS can be a precursor to the development of celiac disease. There is not test for NCGS. Celiac disease must first be ruled out. So, if it becomes apparent that gluten is causing distress and testing rules out celiac disease, then the diagnosis would be NCGS. Hope this helps. 
    • shell504
      I apologize i can't figure out how to get the picture on here.  Results were: IGA 401mg/dl Deamidated Gliadin IGG. <1.0 Deamidated Gliadin IGA. <1.0 Tissue Transglutaminase IGA AB. <1.0 Endomysial IGA. Negative.  Is she just going based off of the IGA alone? And because that is elevated, it's positive? The test states: "Results do not support a diagnosis of celiac disease." 
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