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Non-Celiac Gluten Sensitivity Needs Better Diagnosis Standards - Sfgate


Scott Adams

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SFGate

None of them has celiac disease, whereby gluten elicits an autoimmune response that destroys the lining of the small intestines. Also, none has a wheat allergy, a condition that leads to the release of histamines from immune cells, similar to what ...

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NatureChick Rookie

This article bothers me quite a bit. It is basically advocating for creating guidelines to define a "syndrome", which just means that the medical community doesn't know what is going on but would like an official bucket into which to throw these patients so that they can move on.

How about, instead of creating some guidelines, the medical community does some more research. People are having symptoms that are as bad as if they had celiac disease, but test negative for celiac, and yet they have the same positive results from going gluten-free. So lets figure out what their reactions are and how those reactions can show up in a blood tests. Lets figure out more rather than dump what is probably several different problems into a common bucket and think that we've accomplished something.

spirit22 Newbie

Hi ~ I am new here and am one of those who underwent the celiac panel (tested 8 points high on the tTG IGA but negative on the rest of the panel), underwent endoscopic biopies (several of them, each one cut into smaller pieces by the pathologist) and received a negative diagnosis of celiac. I asked to re-take the celiac panel a week after my endoscopy. Since I had been gluten-free that week, my higher IGA reading had reduced down within the 2/3 normal range.

 

My frustration lies with my gastro doing the procedure and then "letting me go out into the world on my own", with no definitive diagnosis, not even "You MAY have a gluten-sensitivity"! Nor was I instructed to find myself a dietician if I planned to go gluten-free. Has anyone else experienced such indifference?

 

I am seeing my primary doc on June 17th and plan to ask if she will (kindly) order a celiac genetic marker test to see if I might have markers for it. I am hoping I do not have markers but I'd still like to know for sure. Since the endocscopy procedure, my stomach problems have quieted down to almost nil but now I'm having problems in my lower abdomen. To put it mildly, I am struggling here and feel I have no physician input.

 

I have IBS that I am already dealing with and have found that in going off gluten, my IBS-constipation has returned like a demon. I've been reading everything I can get my hands on to find out which gluten-free foods have the most fiber and trying to stay away from the ones who have zilch to little (like white rice). Is anyone else dealing with IBS-C plus gluten-sensitivity? If so, what are you eating and how are you staying out of the constipated zone?

 

Any help is much appreciated!

NatureChick Rookie

IBS is another one of those diagnoses that doesn't actually tell you what the problem is. Either Irritable Bowel Syndrome or Inflammatory Bowel Disease, neither tells you a cause or a solid treatment plan. They aren't actually diagnoses!!!

My "diagnosis" of IBS was actually a B12 deficiency (from malabsorption) that was bad enough to cause abdominal pain. Don't ever be satisfied with an IBS diagnosis. Keep looking for answers. 

spirit22 Newbie

IBS is another one of those diagnoses that doesn't actually tell you what the problem is. Either Irritable Bowel Syndrome or Inflammatory Bowel Disease, neither tells you a cause or a solid treatment plan. They aren't actually diagnoses!!!

My "diagnosis" of IBS was actually a B12 deficiency (from malabsorption) that was bad enough to cause abdominal pain. Don't ever be satisfied with an IBS diagnosis. Keep looking for answers. 

Hi Naturechick ~

 

Thanks for the suggestion about checking my vitamin B-12. I have an upcoming appointment with my primary doc & will inquire about being tested.

NatureChick Rookie

spirit,

I have no idea what might be causing your problems. But at some point, you'll have to stop hoping for other people to solve it for you. All any of us can do is offer ideas to research further, but I wasn't offering ideas above, just ranting against the medical establishment.

spirit22 Newbie

Naturechick ~

 

Thanks for your advice. I really appreciate you taking the time to post.


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    • trents
      NCGS does not cause damage to the small bowel villi so, if indeed you were not skimping on gluten when you had the antibody blood testing done, it is likely you have celiac disease.
    • Scott Adams
      I will assume you did the gluten challenge properly and were eating a lot of gluten daily for 6-8 weeks before your test, but if not, that could be the issue. You can still have celiac disease with negative blood test results, although it's not as common:  Clinical and genetic profile of patients with seronegative coeliac disease: the natural history and response to gluten-free diet: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606118/  Seronegative Celiac Disease - A Challenging Case: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9441776/  Enteropathies with villous atrophy but negative coeliac serology in adults: current issues: https://pubmed.ncbi.nlm.nih.gov/34764141/  Approximately 10x more people have non-celiac gluten sensitivity than have celiac disease, but there isn’t yet a test for NCGS. If your symptoms go away on a gluten-free diet it would likely signal NCGS.
    • Xravith
      I'm very confused... My blood test came out negative, I checked all antibodies. I suppose my Total IgA levels are normal (132 mg/dl), so the test should be reliable. Still, I'm not relieved as I can't tolerate even a single biscuit. I need to talk to my doctor about whether a duodenal biopsy is necessary. But it is really possible to have intestinal damage despite having a seronegative results? I have really strong symptoms, and I don't want to keep skipping university lectures or being bedridden at home.
    • Scott Adams
      They may want to also eliminate other possible causes for your symptoms/issues and are doing additional tests.  Here is info about blood tests for celiac disease--if positive an endoscopy where biopsies of your intestinal villi are taken to confirm is the typical follow up.    
    • Scott Adams
      In the Europe the new protocol for making a celiac disease diagnosis in children is if their tTg-IgA (tissue transglutaminase IgA) levels are 10 times or above the positive level for celiac disease--and you are above that level. According to the latest research, if the blood test results are at certain high levels that range between 5-10 times the reference range for a positive celiac disease diagnosis, it may not be necessary to confirm the results using an endoscopy/biopsy: Blood Test Alone Can Diagnose Celiac Disease in Most Children and Adults TGA-IgA at or Above Five Times Normal Limit in Kids Indicates Celiac Disease in Nearly All Cases No More Biopsies to Diagnose Celiac Disease in Children! May I ask why you've had so many past tTg-IgA tests done, and many of them seem to have been done 3 times during short time intervals?    
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