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Questions About Gastroenterologists


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Generally speaking, are gastroenterologists more celiac-aware and more celiac-friendly than GP


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CarolinaKip Community Regular

Generally speaking, are gastroenterologists more celiac-aware and more celiac-friendly than GP

Roda Rising Star

My original pcp never even brought up celiac when I was having problems. After about a 1 1/2 years with a new endocrinologist I asked her if she knew anything about celiac (I had been doing research for a link between low ferritin/hashimotos and celiac kept coming up) and she said not much except that it was autoimmune and I was probably at greater risk because of the autoimmune thyroid disease. She wrote a lab slip for testing for the tTg only,(I did not know any better at the time) and it came up positive. I basically referred myself to a local GI affiliated with my employer. He did not run anymore tests and I was scheduled for the EGD and biopsy. He seems very aware of celiac and it's complications, but a little outdated on some of the newer testing. He originally told me that my antibodies would stay elevated and never go down. We know better than that since all my antibody levels are now normal except my AGA Igg. I read somewhere on here that the Igg levels can take much longer to come down than the rest, even up to a year. Somebody correct me if I am wrong. After all of this I decided to have a follow up with my PCP to update him on what had been going on. WHAT A COMPLETE JERK! By this point my endocrinologist ran most of my vitamin/mineral tests except vitamin K. I asked him if he would order it since it is common for celiacs to be deficient and that I bruise so much. NOPE! He said he had never ordered one and wasn't going to, that if there was a concern then ask one of my other doctors. We ended up in a very defensive conversation that left me firing is a$$. What it did do for me was to comfirm why I quit seeing him for three years. He was the type that did not like when his patient's went is somewhat educated. I'm still with my GI since I've been having other issues since Jan. He has been very supportive of alot of my suggestions and my want for more conservative measures. There is a new GI joining his practice this month so I may eventually see him too by default. I interviewd a new PCP and had a good first appointment, really nothing more than going over my history and me telling her I was looking for a new doc and I was there to see if she was a good fit for me. One of the first things she said to me that I was fortunate to be diagnosed by positive blood work and relatively quickly (2 1/2 years from onset of symptoms) since so many people get false negative blood work/biopsy. I knew she was a keeper. I've not had a need to see her since my initial consultation since all my trouble has be gi related. Both my gi and new pcp are in the same medical building and can access each others electronic records and tests I have done at the hospital. I usually make copies of my blood work I have done through the endocrinologists office since it is in another town.

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    • Nicbent35
      Well I had a moment yesterday morning where I accidentally gave her gluten. She wanted what I was eating and I forgot and let her have a few bites of toast. It was a really bad night last night with her behavior. Will a few bites of bread influence their behavior that much or could it just be a coincidence?
    • Scott Adams
      The first set of results show two positive results for celiac disease, so at the very least it looks like you could have it, or at the least NCGS.   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.      
    • Scott Adams
      Elevated tissue transglutaminase IgA (tTG-IgA) levels are highly specific for celiac disease, and they are a key biomarker used in its diagnosis. However, there are some rare instances where elevated tTG-IgA levels have been reported in conditions other than celiac disease. While these cases are not common, they have been documented in the literature. Below are some examples and references to studies or reviews that discuss these scenarios:  1. Non-Celiac Gluten Sensitivity (NCGS)    - NCGS typically does not cause elevated tTG-IgA levels, as it is not an autoimmune condition. However, some individuals with NCGS may have mild elevations in tTG-IgA due to intestinal inflammation or other factors, though this is not well-documented in large studies.    - Reference: Catassi, C., et al. (2013). *Non-Celiac Gluten Sensitivity: The New Frontier of Gluten-Related Disorders*. Nutrients, 5(10), 3839–3853. [DOI:10.3390/nu5103839](https://doi.org/10.3390/nu5103839)  2. Autoimmune Diseases    - Elevated tTG-IgA levels have been reported in other autoimmune conditions, such as type 1 diabetes, autoimmune hepatitis, and systemic lupus erythematosus (SLE). This is thought to be due to cross-reactivity or polyautoimmunity.    - Reference: Sblattero, D., et al. (2000). *The Role of Anti-Tissue Transglutaminase in the Diagnosis and Management of Celiac Disease*. Autoimmunity Reviews, 1(3), 129–135. [DOI:10.1016/S1568-9972(01)00022-3](https://doi.org/10.1016/S1568-9972(01)00022-3)  3. Chronic Liver Disease    - Conditions like chronic hepatitis or cirrhosis can sometimes lead to elevated tTG-IgA levels, possibly due to increased intestinal permeability or immune dysregulation.    - Reference: Vecchi, M., et al. (2003). *High Prevalence of Celiac Disease in Patients with Chronic Liver Disease: A Role for Gluten-Free Diet?* Gastroenterology, 125(5), 1522–1523. [DOI:10.1016/j.gastro.2003.08.031](https://doi.org/10.1016/j.gastro.2003.08.031)  4. Inflammatory Bowel Disease (IBD)    - Some patients with Crohn’s disease or ulcerative colitis may have elevated tTG-IgA levels due to intestinal inflammation and damage, though this is not common.    - Reference: Walker-Smith, J. A., et al. (1990). *Celiac Disease and Inflammatory Bowel Disease*. Journal of Pediatric Gastroenterology and Nutrition, 10(3), 389–391. [DOI:10.1097/00005176-199004000-00020](https://doi.org/10.1097/00005176-199004000-00020)  5. Infections and Parasites    - While infections (e.g., giardiasis) are more commonly associated with false-positive tTG-IgA results, chronic infections or parasitic infestations can sometimes lead to elevated levels due to mucosal damage.    - Reference: Rostami, K., et al. (1999). *The Role of Infections in Celiac Disease*. European Journal of Gastroenterology & Hepatology, 11(11), 1255–1258. [DOI:10.1097/00042737-199911000-00010](https://doi.org/10.1097/00042737-199911000-00010)  6. Cardiac Conditions    - Rarely, heart failure or severe cardiovascular disease has been associated with elevated tTG-IgA levels, possibly due to gut ischemia and increased intestinal permeability.    - Reference: Ludvigsson, J. F., et al. (2007). *Celiac Disease and Risk of Cardiovascular Disease: A Population-Based Cohort Study*. American Heart Journal, 153(6), 972–976. [DOI:10.1016/j.ahj.2007.03.019](https://doi.org/10.1016/j.ahj.2007.03.019)  Key Points: - Elevated tTG-IgA levels are highly specific for celiac disease, and in most cases, a positive result strongly suggests celiac disease. - Other conditions causing elevated tTG-IgA are rare and often accompanied by additional clinical findings. - If celiac disease is suspected, further testing (e.g., endoscopy with biopsy) is typically required for confirmation. If you’re looking for more specific studies, I recommend searching PubMed or other medical databases using terms like "elevated tTG-IgA non-celiac" or "tTG-IgA in non-celiac conditions." Let me know if you’d like help with that!
    • MaryMJ
      I called zero water and they state their filters do not contain gluten or gluten containing ingredients. 
    • trents
      I agree. Doesn't look like you have celiac disease. Your elevated DGP-IGG must be due to something else. And it was within normal at that after your gluten challenge so it is erratic and doesn't seem to be tied to gluten consumption.
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