Trying To Get Diagnosed During Visit To Belgium - Should I Start Eating Gluten?

[naturegirl]

Hello all,

I'm going back to Europe for 3 weeks in a week, including 10 days in Brussels and want to try to get a diagnosis while I am over there (as it is WAY WAY more affordable). I wanted to know if anyone knows of a gastro-enterologist for adults in Brussels (only found dr's in other parts of Belgium or pediatricians in Brussels on the forum). I am not sure that I will be able to get an appointment this late in the day anyway... and I have already emailed a few dr's to try to get an appointment. I should see a gastro-enterologist rather than an allergist, right?

Also, I have been off gluten for 13 months. If I am able to schedule a colonoscopy (plus biopsy?) should I start eating gluten for the 10 days/2 weeks before I have it (or is that too short a time period anyway)? Of course, I really don't want to eat gluten (as it makes me feel terrible, I have no desire to eat it anymore!!!) but I will if I have to do so to get a clear diagnosis (apparently I can also get a little money for the extra cost in food through the Belgian government - the beauty of the European health system! - but only if I get diagnosed as celiac).

If I do need to eat gluten for the diagnosis, any suggestions on how much and how to introduce it to have enough to facilitate the diagnosis but have the least symptoms?!?

Thanks so much for all your help!!! It is much appreciated.

[ravenwoodglass]

You need to be back on gluten for about 2 to 3 months for any chance of an accurate biopsy or blood test. Are you from Belgium and a citizen? I don't know how their medical system works if you are not a resident but doing a challenge for 2 to 3 months to get a bit of help with food costs for 3 weeks doesn't seem worth it to me. I would just stay on the diet if it is helping.

If you can get an appointment you would need to see a gasteroenterologist and you would need an endoscopy not a colonoscopy.

[naturegirl]

  On 7/13/2010 at 7:34 PM, ravenwoodglass said:

You need to be back on gluten for about 2 to 3 months for any chance of an accurate biopsy or blood test. Are you from Belgium and a citizen? I don't know how their medical system works if you are not a resident but doing a challenge for 2 to 3 months to get a bit of help with food costs for 3 weeks doesn't seem worth it to me. I would just stay on the diet if it is helping.

If you can get an appointment you would need to see a gasteroenterologist and you would need an endoscopy not a colonoscopy.

Thanks a lot for the advice. That is good to know that it takes several months. I may try to get an appointment with a gastroenterologist this time around and talk to them about getting an endoscopy and biopsy when I return to Belgium at Christmas time. If I got diagnosed with celiac the Belgian healthcare system would help me financially for the rest of my life (small amount but it might still be worth it). I believe that this would be true even if I am living abroad. I am not actually a Belgian citizen (I am dual British-American) but as the UK has free medical care and I lived in Belgium and they are both part of the EU I can get all my Belgian treatments reimbursed... (paying the 'mutuelle' which is a kind of state funded health insurance 75EUR/year). It is quite amazing! So I try to do every 'check up' (dentists, gynecologist...) when I am back there because each visit is free of costs less than 20EUR once I'm reimbursed. Also the doctors spend a lot more time with you (and there are not the crazy long waiting lists like in the UK). I feel extremely lucky to have access to the Belgium health system, especially with all the health problems that I have been experiencing.

The other reason that I would like to get some kind of diagnosis is that I am still unwell after being on the gluten free diet for over a year. I have never done a 'gluten challenge' so I am not 100% certain that my health problems are primarily gluten-related. I would be happy to stay off gluten for the rest of my life as I have noticed some improvement but if I need to avoid it down to the crumb, make a fuss in restaurants... I would like to be sure that it is worth it. And also that there is not something else going on.

Thanks again for the advice.

[ravenwoodglass]

It sounds like you have a solid plan. Do start your gluten challenge about 3 months before you go back for Christmas. If you can get into the GI this trip they can always see if something else is going on. Your continued issues could be from not being superstrict on the diet but it is never a bad idea to rule out other problems. Being gluten free will only effect testing for celiac it will not interfere with other tests.

[Gemini]

  On 7/14/2010 at 4:00 PM, naturegirl said:

Thanks a lot for the advice. That is good to know that it takes several months. I may try to get an appointment with a gastroenterologist this time around and talk to them about getting an endoscopy and biopsy when I return to Belgium at Christmas time. If I got diagnosed with celiac the Belgian healthcare system would help me financially for the rest of my life (small amount but it might still be worth it). I believe that this would be true even if I am living abroad. I am not actually a Belgian citizen (I am dual British-American) but as the UK has free medical care and I lived in Belgium and they are both part of the EU I can get all my Belgian treatments reimbursed... (paying the 'mutuelle' which is a kind of state funded health insurance 75EUR/year). It is quite amazing! So I try to do every 'check up' (dentists, gynecologist...) when I am back there because each visit is free of costs less than 20EUR once I'm reimbursed. Also the doctors spend a lot more time with you (and there are not the crazy long waiting lists like in the UK). I feel extremely lucky to have access to the Belgium health system, especially with all the health problems that I have been experiencing.

The other reason that I would like to get some kind of diagnosis is that I am still unwell after being on the gluten free diet for over a year. I have never done a 'gluten challenge' so I am not 100% certain that my health problems are primarily gluten-related. I would be happy to stay off gluten for the rest of my life as I have noticed some improvement but if I need to avoid it down to the crumb, make a fuss in restaurants... I would like to be sure that it is worth it. And also that there is not something else going on.

Thanks again for the advice.

I don't think that UK citizens have free health care....they pay hefty taxes on everything to fund the system. That part of the equation is never published. I have friends in Britain and go there quite often to visit and they definitely pay more taxes than the average American does.

Good luck with obtaining a diagnosis. You will have to do a gluten challenge but you may get your answer from that alone.

It also sounds like you could have additional intolerances as that might explain why you still feel unwell after a year gluten-free.