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Any Good Doctors In Sacramento Ca Area
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I am trying to find a good GI in the Sacramento area although I would go to the Bay area or Stanford if needed. I saw a GI doctor recently who wanted me to go on a gluten challenge for a definite diagnosis of Celiac. I had gone off gluten myself and was diagnosed by blood tests and symptoms by my rheumatologist. I don't think a gluten challenge is wise after all I have read and would like to find a doctor experienced with Celiac disease and Gluten intolerance. Any advice?

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I am trying to find a good GI in the Sacramento area although I would go to the Bay area or Stanford if needed. I saw a GI doctor recently who wanted me to go on a gluten challenge for a definite diagnosis of Celiac. I had gone off gluten myself and was diagnosed by blood tests and symptoms by my rheumatologist. I don't think a gluten challenge is wise after all I have read and would like to find a doctor experienced with Celiac disease and Gluten intolerance. Any advice?

Sounds like you were already diagnosed by an MD with out a cruel streak.

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Sounds like you were already diagnosed by an MD with out a cruel streak.

Yes that is true! I would just like someone who is experienced to follow me with this disease. My Rheumatologist doesn't know much about Celiac. She said it was just a hunch!

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I don't think you'll get much help beyond "don't eat gluten" but I really liked Dr Jane Melnick in San Francisco. She's a smart lady and very kind.

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I had to press my Doctor for a blood test. I had many symptoms including severe fatigue, headaches, joint pain, leg pain, Ibs, and she wanted to test me for everything but...

She finally tested me when everything else came back negative and it turned out I had antibodies for celiac spru. So she said to me "Gluten Free Diet". I haven't had any professional help since (Jan 2010)

I still don't feel 100% and wonder if a GI should be tracking my health.

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    • Squirmingitch, I forgot to mention best of luck to you during the storm! I hope you are safe and that your home isn't impacted too badly! I'm on the coast in SC so we will see some storms from it but nothing near as bad as what you will have. Take care and good luck.
    • SquirmingItch, I really appreciate you gathering info for me! To answer your questions, yes, I'm on Dapsone now and have been on it for about 4.5 weeks. I have been gluten free for the same amount of time. I started on 50 mg of Dapsone which didn't seem to help much. I spoke to my doctor about it and after about a week she raised it to 100 mg. Since then I did notice a huge improvement in both my rash and itch. I no longer have any active rashes and my itching isn't completely gone but it's very minimal. I have been getting weekly blood tests done and will soon be moving to monthly.  My DH skin biopsy was done before the gluten free diet and Dapsone. My results for the skin biopsy came back as inconclusive, but even with those results, my doctor was convinced I had DH. I specifically asked her about the fact that she took the biopsy directly from the lesion rather than next to it and if that affects the result. Her explanation was that if it's a fresh enough lesion that isn't scratched, there should be IgA antibodies present. But she said that an inconclusive result isn't surprising because the IgA antibodies come and go from the skin so quickly that it can be very difficult to get a positive result, even in someone who is positive.  That's when she decided to run the celiac blood panel on me. And even though those results came back positive for the deamidated gliadin and negative for tTg, she still is very convinced that I have DH. I am happy that my doctor seems to be certain, but I would just feel better if the results were more definitive. The one other thing I am waiting on is I have been asked to attend grand rounds at the local academic hospital in 2 weeks. I guess grand rounds is where all of the academic dermatologists and dermatopathologists get together to review certain complicated cases. They will meet with me, review all of my pictures, biopsies and blood tests. My situation has been so complicated so they asked me to come. I am hoping maybe then I will get some more answers. 
    • It sure is, it really is. 
    • shellyb, I have info. for you & you may yet be able to get an official dx from your dermatologist as she sounds like she would be willing to learn. If you are dx'd with dh it is definitive & no other testing is needed. You don't need to see a GI. Im in FL & have had a long day watching Tropical Storm Hermine & making preparations for it's track which is over where I live. I'm tired! I will have links for you to reputable medical info. on the rash but it make take me till tomorrow or even longer if we lose power.  I'll be back as soon as I can. Question: You're on Dapsone now? How long have you been on it? How is it working for you? Are you getting the proper testing at regular intervals to make sure it isn't doing bad things to you? Were you gluten free before the skin biopsy?
    • Thank you so much for your quick response, GFinDC. While I wouldn't be completely opposed to another skin biopsy, I already had 4 done (3 were done prior to my dermatologist suspecting DH) so I don't love the idea of  yet another hole and scar on my body. Plus, fortunately I don't have any fresh lesions now, which I believe is needed for the biopsy. I wish I would have known to see a GI before going gluten free but I was so desperate to get any relief that I started that and Dapsone as soon as my doctor mentioned it to me.  My rash is definitely symmetrical and I have it in all of the "classic" DH spots although it basically spread over my entire body. As much as I'd like a more formal diagnosis, I really don't think I can go through all of that again. It was so bad that not only was I getting no sleep but I had to change my sheets every morning because there was blood all over them. Sorry, TMI. The worst part is that this all developed during my ninth month of pregnancy and got much worse after I delivered my baby. So not only was I dealing with this insanely itchy rash but I had a newborn and a toddler to take care of.  My daughters' pediatrician did mention doing DNA testing on me first and then my daughters to see if there's any concern that they may be susceptible. I may just go that route for now. I was just curious if others have had similar test results to mine and how did their doctors treat it? Thanks again!
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