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No Villi Visible After gluten-free For Over A Year?


HS7474

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HS7474 Apprentice

I was talking to my mom regarding the biopsy I had in March. I had been (and still am) gluten-free for over a year up to that point. Apparently the doctor said that he could not see any villi on my intestine when he did the endoscopy. I believe I tested negative for everything (including celiac disease). Is it normal for my villi to remain damaged for so long? I had thought they started healing immediately.

Thank you!


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ravenwoodglass Mentor

Did your doctor biopsy? The villi are not visible with the naked eye. If your villi are still absent or severely blunted you are likely still getting gluten somewhere. It can take some time for us to heal. In rare cases folks can have something called refractory sprue where they don't heal even on the diet. Many of them are found to not be as gluten free as they need to be though. How are you feeling? Are you still having symptoms? Are you eating a mostly whole unprocessed diet, taking care against cross contamination and have you eliminated gluten from topical products? Be aware that some of us do not tolerate distilled gluten grains so if you are consuming distilled gluten alcohols you may want to stop for a while and see if it helps.

Paula Wallah Newbie

I have had the same experience. Gluten-free for nearly a year and still no villi. And I am still so sick.....

HS7474 Apprentice

They did do a biopsy and I meant to call and get the results again. I'll do that tomorrow as I think they are closed for the rest of today.

I was having some syptoms but believe they are attributed to the sugarfree gum I was constantly chewing - since I've stopped I'm feeling much, much better if not completely. I do drink distilled alcohols, and had a drink last night, but don't believe I had any symptoms. As well, most of the food I eat is unprocessed. I did have very mild symptoms today without explanation, unless the drink last night is to blame. It was nothing to bother over though and could have just been normal body functions at work :)

Cypressmyst Explorer

Have you been checked for parasites and infections? I know that cryptosporidium damages the villi just as badly as gluten for example.

ravenwoodglass Mentor

I have had the same experience. Gluten-free for nearly a year and still no villi. And I am still so sick.....

Have you eliminated the possibility of other intolerances as well as being very careful about cross contamination? The most common other intolerances are dairy and soy.

cassP Contributor

even tho, technically "gluten" from wheat, rye, and barley is the only thing that destroys the villi in those with Celiac-> i TOTALLY have read and believe that countless intolerances (especially dairy & corn/other grains) for SOME people could aggravate the intestines to where they can't heal properly. idk... just a thought.

Also- ive read that Candida has a similar structure to gliadin and can trigger celiac- so maybe Candida can also inhibit the healing of the villi... idk????

hope you get somewhere good soon


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T.H. Community Regular

When I was diagnosed, my GI said that the following could impede healing

1) any other food allergies and intolerances, even allergies mild enough not to cause hives or rashes

2) Dairy. If you have no villi, you are not making lactase - it's made in the tips of the villi, as I understand it.

3) drinking alcohol - he recommended that I stay away from it until I was healed.

He said that it could be up to 2 years to heal in celiacs, but there should be some change, by 1 year, I would think.

I would second Ravenwoodglass - you could be getting too much gluten for your system to handle. Something to remember is that 'gluten free' only means that the food has less than a certain amount of gluten (or is presumed to have less than, if it's untested). It's just a legal label.

Gluten contamination is pretty common in the food industry, so if you have any foods that don't have gluten ingredients, that doesn't always mean they don't have gluten contamination. And labels like 'processed on equipment that also processes wheat' are voluntary, not legally required.

A good example is corn tortillas. They have no gluten ingredients, but can be made right next to equipment that process wheat tortillas. And then the flour poofs in the air and settles onto the corn tortillas, and they become contaminated.

Do you work or live in any area with a lot of flour in the air, or a lot of construction? Inhaled gluten tends to be digested as it gets into your throat. Many construction materials have gluten, like drywall dust and sawdust from plywood.

Also, since you're dating - Anything on your partner that might touch your lips when you kiss can get gluten into you also. Lipstick, chapstick, body or face lotion, makeup. Have you checked your hygiene products? toothpaste, flavored floss, shampoo if it ever gets into your mouth when rinsing off.

Good luck, and heres hoping you find the naswer soon.

  • 10 months later...
Lori M Newbie

I was talking to my mom regarding the biopsy I had in March. I had been (and still am) gluten-free for over a year up to that point. Apparently the doctor said that he could not see any villi on my intestine when he did the endoscopy. I believe I tested negative for everything (including celiac disease). Is it normal for my villi to remain damaged for so long? I had thought they started healing immediately.

Thank you!

Yes, its called Fructose Malabsorbtion. Not until I went on a LOW FODMAP diet did I start to heal. Look up a study called Sugar Malabsorbtion in Children by the Australlian Gastro Institute to read about how frutose does the same to villi as gluten.

Read about chronic malabsorbtion, and wiki the small intestine. 30 percent of us are fructose intolerent, gluten is only one of these sugars. dig deeper.

Gluten is only the tip of the iceburg. Garlic,, onion, raisins, honey, cabbage, mushrooms, fruits, and sugar free crap is some of the worst offenders. I did always wonder why a mountain dew or a margarita made me feel like puking after one....now I know.

Low Fodmap is where its at, trust me! I saw a shift of symptoms going just gluten free, as I was eating more fruit and veggies and getting sicker, but different kinds of sicker...more insomnia, more arms and legs going numb...more headaches, more fatigue and depression, more edema and weight gain... Now I know why, ... Fructose MALABSORTION!

Hydrogen breath test if you must confirm, but I dont need anymore doctors to lie to me and run up any more bills. Its all in the food, and there is no copay due for this.... lol.

-Lori

Lori M Newbie

I have had the same experience. Gluten-free for nearly a year and still no villi. And I am still so sick.....

Research Fructose Intolerence or Malaborbtion of Fructose. Missing enzyme. Low FODMAP diet works best. Was sick for a decade before I figured it out. Good luck. The Intolerent Diner site has a pretty good list of FODMAPS to avoid...its a start.

Lori

Lori M Newbie

When I was diagnosed, my GI said that the following could impede healing

1) any other food allergies and intolerances, even allergies mild enough not to cause hives or rashes

2) Dairy. If you have no villi, you are not making lactase - it's made in the tips of the villi, as I understand it.

3) drinking alcohol - he recommended that I stay away from it until I was healed.

They left off a biggie to check... FRUCTOSE MALABORBTION... 30 percent of us have it, yet the doc says NOTHING about that. LOW FODMAP healed ME! Garlic, onions, raisins, honey, sugar free stuff, cabbage, apples, pairs, peaches, plums, mushrooms,.... Look up Study: Sugar Malabsorbtion in Children by Australlian Gastro institute. Hope this helps.

  • 5 weeks later...
Aly1 Contributor

You are getting lots of good advice...

You mention that you drink distilled alcohols. I can't tolerate those, despite the claims that they are okay. Maybe avoid that for now and see...I now drink potato vodka which has been fine.

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    • CC90
      Hi Cristiana   Yes I've had the biopsy results showing normal villi and intestinal mucosa.  The repeat endoscopy (requested by the gastro doc) would be to take samples from further into the intestine than the previous endoscopy reached.      
    • Wheatwacked
      Transglutaminase IgA is the gold-standard blood test for celiac disease. Sensitivity of over 90% and specificity of 95–99%. It rarely produces false positives.  An elevated level means your immune system is reacting to gluten.  Non-Celiac Gluten Sensitivity (NCGS) does not typically cause high levels of tTG-IgA. Unfortunately the protocols for a diagnosis of Celiac Disease are aimed at proving you don't have it, leaving you twisting in the wind. Genetic testing and improvement on a trial gluten free diet, also avoiding milk protein, will likely show improvement in short order if it is Celiac; but will that satisfy the medical system for a diagnosis? If you do end up scheduling a repeat endoscopy, be sure to eat up to 10 grams of gluten for 8 - 12 weeks.  You want  to create maximum damage. Not a medical opinion, but my vote is yes.
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      Cristiana asks a very relevant question. What looks normal to the naked eye may not look normal under the microscope.
    • cristiana
      Hello @CC90 Can I just ask a question: have you actually been told that your biopsy were normal, or just that your stomach, duodenum and small intestine looked normal? The reason I ask is that when I had my endoscopy, I was told everything looked normal.  My TTG score was completely through the roof at the time, greater than 100 which was then the cut off max. for my local lab.  Yet when my biopsy results came back, I was told I was stage 3 on the Marsh scale.  I've come across the same thing with at least one other person on this forum who was told everything looked normal, but the report was not talking about the actual biopsy samples, which had to be looked at through a microscope and came back abnormal.
    • trents
      My bad. I should have reread your first post as for some reason I was thinking your TTG was within normal range. While we are talking about celiac antibody blood work, you might not realize that there is not yet an industry standard rating scale in use for those blood tests so just having a raw number with out the reference scale can be less than helpful, especially when the test results are marginal. But a result of 87.4 is probably out of the normal range and into the positive range for any lab's scale. But back to the question of why your endoscopy/biopsy didn't show damage despite significantly positive TTG. Because they took the trouble to take seven samples, it is not likely they missed damage because of it being patchy. The other possibility is that there hasn't been time for the damage to show up. How long have you been experiencing the symptoms you describe in your first post? Having said all that, there are other medical conditions that can cause elevated TTG-IGA values and sometimes they are transient issues. I think it would be wise to ask for another TTG-IGA before the repeat endoscopy to see if it is still high.  Knitty kitty's suggestion of getting genetic testing done is also something to think about. About 35% of the general population will have one or both genes that are markers for the potential to develop active celiac disease but only about 1% of the population actually develop celiac disease. So, having a celiac potential gene cannot be used to definitively diagnose celiac disease but it can be realistically used to rule it out if you don't have either of the genes. If your symptoms persist, and all testing is complete and the follow-up endoscopy/biopsy still shows no damage, you should consider trialing a gluten free diet for a few months to see if symptoms improve. If not celiac disease, you could have NCGS (Non Celiac Gluten Sensitivity). 
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