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Refractory Sprue


ryebaby0

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ryebaby0 Enthusiast

I just wondered what your experiences with GIs regarding "refractory sprue" are. We had a consult with an experienced celiac GI and I was surprised that the (apparent) current thinking/research is that there really is no such thing as "refractory sprue" -- if you don't respond to a strict gluten-free diet clincally and/or pathologically, then by definition you don't have any form of celiac sprue, you have some other autoimmune problem manifesting itself as a celiac look-alike. (probably autoimmune enteropathy). I couldn't believe that after months of a gluten-free diet now we're being told that it may not be neccessary at all (or at least until my son heals, which will probably take the better part of a year)

Joanna


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    • trents
      Most recent gluten challenge guidelines call for the consumption of at least 10g of gluten (about the amount in about 4-6 slices of wheat-based bread) for at least 2 weeks.  When celiacs have been on gluten free diets for long periods of time, they often find that when they consume a good amount of gluten, they react much more strongly than they did before going gluten free. They have lost all tolerance to the poison they had when consuming wheat products regularly. That is certainly the case with me. A couple of years ago I accidentally consumed a wheat biscuit my wife had made thinking it was a gluten free one and it made me violently ill. So, I mention that as I don't know if your son has started the gluten challenge yet.
    • melthebell
      Will definitely keep you posted. We live in Japan and will fly to Australia for the endoscopy end of April so until then, for the next ten weeks, we will just start adding gluten daily. 2 slices of white bread a day is what the guidelines seem to say.    But I welcome advice from members here who have done successful gluten challenges. I know they are not always successful.    I have also read I should monitor his growth. Is that really a concern for 10 weeks of gluten consumption? He is growing and has always followed his curve but he’s no basketball player at 20-25th centile. 
    • trents
    • trents
      @melthebell, keep us posted. We are learning more and more about gluten disorders as time goes on. One of the things that has become apparent to me is that gluten disorders don't always like to fit into the neat little pigeon hole symptomatic and diagnostic paradigms we have created for them. There seems to be a lot more atypical stuff going on than we once realized.
    • melthebell
      Thanks very much for taking the time to write. I have been reading a lot about this and it definitely is not straight forward. My first port of call is the gene test - probably should have had it done before we left Australia because they don’t run the test in Japan. So I’ve ordered a third party test kit and just swabbed his cheek. Then we start the gluten challenge and see how it goes. 
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