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Lymphoid Aggregate In Terminal Ileum
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Does anyone know what it means have a biopsy of the terminal ileum (done during a colonoscopy) show a "lymphoid aggregate"? It says there's no evidence of an inflammatory bowel disease, and that this is benign and not cancerous. So I'm assuming the lymphoid aggregate is nothing too significant, but I'm curious about what it means. Could gluten cause it? 

 

When they did my upper endoscopy last year they only took four samples, with none from the duodenal bulb, and no lymphocyte counts. The GI assured me beforehand that she'd do plenty of biopsies, but I woke up and found out she'd only done four. And I'd been gluten-light for over a decade, then briefly gluten free, then did a six-week gluten challenge leading up to the endoscopy (during which I only had one piece of bread most days because it was making me so miserable and my hair started falling out). So altogether, there were many places where doubt crept in about whether this had really been enough to rule out celiac. I'm sticking to the diet, regardless, as the improvements have been huge and life-changing. But I guess I'm still trying to piece together a coherent explanation of what's going on. The GI also made blatant factual errors about my family history on the colonosopy report, so in general I'm not sure if she's even reading my file or reports carefully. 

 

I guess what I'm really wondering is whether a "lymphoid aggregate" way down at the end of the small intestines could be caused by celiac or NCGS, or whether it's totally unrelated. The procedural report did note that she was able to get the scope up through the colon and into the terminal ileum unobstructed. 

 

 

 

 

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I had a mass the size of a orange in my mediastinum that I had removed in December of 2010.  It was a mass of lymph cells, all benign.  At the time the doctors really had no clue what caused it.  After my celiac diagnosis my doctor and I were talking and he said it might of had to do with the fact that the lymphatic system releases lymph cells to counter act inflammation and sometimes they can congregate in places where there is a lot of inflammation.  Why they ended up in my chest is a mystery, but I was having a lot of chest, shoulder and back pain for years before that and our digestive system goes from your mouth to anus so it is safe to say that there might be inflammation in those areas as well.  Maybe it is from an inflammatory response in your intestines.  While the report stated there was no inflammatory bowel, that doesn't mean it wasn't inflamed before.  Just a thought.

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Wow, that's a big mass you had! Interesting about lymph masses in general - that makes sense. I've been strictly gluten free for over a year, so I wouldn't expect to have active inflammation from gluten anymore, but my endoscopy last year did find inflammation in my esophagus and stomach (plus a hiatal hernia). My tongue also stayed swollen for months after my gluten challenge, and it eventually went most of the way down after I cut out sulfites too. So there certainly has been inflammation in my digestive tract!

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    • Another link: http://naldc.nal.usda.gov/download/7351/PDF
    • Thanks for posting.  I know it is difficult to talk about these sorts of things even on a webforum.  It is good thing for people to be aware though about celiac disease and that it can cause mental problems.  Gluten can cause brain damage and it can cause anxiety. If the brain does heal it may take a long time. I know that gluten can cause anxiety and obsessive thoughts.  My experience has been similar to your experience. When I first quit eating gluten I had a similar constant loop and strong negative feelings. There are lots of people on this forum who get anxiety when they eat gluten. Some people also experience gluten withdrawl where they experience anxiety after giving up gluten. It can take a long time for the body to heal and for obsessive thoughts to go away.
       It is normal for people to socialize with each other and to be comfortable about it. You said you have problems still socializing and being around people. It might be a depressing thought but it sounds to me like you still have problems with anxiety.  I would recommend considering what options you have available to treat the anxiety. When I quit eating Gluten I still had some symptoms, even though I felt much better. I have been slowly recovering over a period of about three years. I had obsessive thoughts even after I quit eating gluten.  Now I very rarely if at all think about those things. My experience is that my mind would latch on to certain things that caused me anxiety and focus on those things. Sometimes my focus would shift and I would latch onto other things. My ability to socialize has also improved greatly with time. I have made some dietary changes which I believe have helped greatly. It sounds to me like you have obsessive thoughts about things and maybe some brain damage. My experience has been that my obsessive thoughts about different things went away with time. I feel my obsessive thoughts were caused by gluten and not by what people did around me or any events. As my brain healed I became more self aware and things became less stressful.  I can't give medical advice on this forum but I can talk about my current diet and my experience with celiac disease. My experience with gluten is different from a lot of other people so it is a good idea to ask other people and to talk to a doctor.  I avoid oats and avoid almost all processed foods. I buy certified gluten free food. I eat healthy and I exercise every day. I take st John's Wort as I have read studies that say it may be as effective as some other anti-depressants for treating certain types of anxiety. It is available over the counter. I started with a small dosage and then stepped it up over time. I think it helps a lot.  This is also something that you should talk to a doctor about first. https://www.researchgate.net/profile/Martin_Mahoney2/publication/7426926_St._John's_wort/links/540d8acc0cf2f2b29a386673.pdf A lot of people with celiac disease have vitamin deficiencies.  Vitamin b deficiency can cause anxiety. Some people do not process the synthetic form of vitamin b (from normal pills)  very well, and do better on an activated form of vitamin b. I take:
      1 activated vitamin b12 daily
      1 activated vitamin b6 every once in a while. 1 regular vitamin b multivitamin
      1 magnesium pill every day.
      St Johns Wort daily.
      1 zinc vitamin daily
      I drink lots of Chamomile tea and decaf coffee. I avoid most caffeine. 
      I think each of these helps lower my anxiety level.  I eat fruit with every meal. Canned fruit from walmart is cheap and good for you. I eat salad and and vegetables and avoid dairy.  I eat frozen fish often as it has healthy proteins. Eating healthy is very important. I eat potatoes and rice. http://www.livestrong.com/article/454179-what-is-methyl-b12/ I avoid eating soy sauce, soy, cheese, aged meats and fermented foods (I do drink certain types of alcohol in moderate amounts.) These foods contain lots of Tyramine. I might (or might not) have "monoaine oxidase deficiency" and if so high Tyramine foods should be avoided.  I thought I might have problems with elevated ammonia in my blood, but I am not convinced of that anymore. I limited my consumption of meat for a while as well as dairy but I am not sure if i helped.  I have heard that Celiac disease can effect other organs besides the brain and those organs can have an effect on the brain.  My current diet is working so I am going to stick with it for now. I try not to worry about things that are outside of my control. Be patient as it took me a long time to recover.  Let me know if you have any questions. There is a lot of information on this site and people who are willing to help.
       
    • Thank you. This is really helpful. I will call around next week.  I just want to heal! 
    • My endoscopy showed i had decreased folds in my duodenum. The biopsy came back and showed that my villi were fine... i have been on a gluten free diet for 6 years because i was just told i was intolerant but never had any testing before. when i eat gluten i get sick for 2 weeks. i came down with issues of other foods in march so they were trying to figure out why and wanted to know if i had celiac are not because that would explain why dairy and fructose are a problem.. both intolerant test for both were negative but the fructose test made me extremely sick but it was negative...      Im trying to figure out why i have decreased  folds in the first place. my Gi doctor is stumped on that to why the endoscopy would show damage but the under the microscope are fine. She is going to call the dr who did my scope and then is supposed to get back to  me..    would being gluten free for 6 year make it so there was damage and then my vili are now fine but still cant be seen in the endoscope?
    • Spicely Organics has both cassia and true (Ceylon) Cinnamon and are certifed gluten free along with the rest of their spices, as to tea Republic of Tea has most of their products tested and certified gluten-free also. You can visit their sites or try Amazon.
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