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Don't Know What To Do


strum

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strum Rookie

I go back for my follow up with my GI doc tomorrow. My blood tests were negative and my biopsy was suggestive of Celiac's but not positive. However, I have been inadvertently eating a very low gluten diet for three months by eating low carb. No bread, pasta, crackers, etc. I know the normal answer would be do a gluten challenge but I tried and it makes me so sick I can't work. I can't miss six weeks of work. And I can't stand the thought of just being that sick. So, not sure what to do or say tomorrow. I welcome any suggestions.


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BlessedMommy Rising Star

What did they see on the biopsy? Seems to me that if they saw damage, then it's celiac.

 

Because being celiac is kind of like being pregnant, either you are or you aren't. You can't be a "little celiac." I'm not sure why they would say it's "suggestive of celiac" but not positive?

SMRI Collaborator

My biopsy results say that it's likely celiac but it also lists some other conditions that it could be like bacterial overgrowth so it isn't always cut and dried. Now, my blood work and genetic test came back positive to support the biopsy findings.

Is having the official diagnosis needed for something at work or elsewhere?

BlessedMommy Rising Star

Oh okay, that makes sense! So apparently there are other things that can affect the gut?

strum Rookie

I guess that's what it comes down to, do I need the diagnosis. Personally, I would very much like to know for sure. I think compliance and understanding would be much easier with a definitive diagnosis. I'm not sure how it might effect things down the road as far as insurance or work, I just don't know.

sweetsailing Apprentice

Given the uncertainess with your tests and eating very little gluten at the time of testing.  I would make sure that you get genetic testing done.  While it can't conclude that you absolutely have celiac.  It can rule in or out the possibility and provide one more piece of the puzzle that would help support a diagnosis.

LauraTX Rising Star

Have you had the genetic test done? That plus the biopsy may give some more clues


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strum Rookie

So, my doctor basically said he doesn't know what's wrong with me but if gluten makes me sick and not eating gluten makes me better he would like to try for months with a gluten free diet and see how I do. I'm not thrilled with not knowing, but I am happy at not doing a gluten challenge.

cyclinglady Grand Master

I was formally diagnosed last year, but my husband (who has been gluten-free for 13 years per the advice of his doctor), was not. It was hard for him to comply with the diet in the beginning, but after a while he realized how much better he felt. He gets sick if he accidentally gets glutened just like me!

So, it is possible to go without a formal diagnosis, but he would be the first one to tell you that I have received a lot more support from family, friends and medical. I have an Aunt and cousin who both have given up gluten after inconclusive tests. They do not want to do the challenge now that they have been gluten free for over a year.

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      Thanks to both of you for your responses!  Sadly, even after several years of very strict gluten avoidance, I remember the symptoms well enough that I am too frightened to risk a gluten challenge— heartbeat and breathing problems are scary— Scott, thank you for the specific information— I will call around in the new year to see if I can find anyone. In the meantime, I will carry on has I have been— it’s working! Thanks also for the validation— sometimes I just feel crushed by disbelief. Not enough to make me eat gluten though—
    • trents
      Welcome to the celiac.com community, @GlorietaKaro! As Scott indicated, without formal testing for celiac disease, which would require you to have been consuming generous amounts of gluten daily for weeks, it would be not be possible to distinguish whether you have celiac disease or NCGS (Non Celiac Gluten Sensitivity). Their symptoms overlap. The difference being that celiac disease is an autoimmune disorder that damages the lining of the small bowel. We actually no more about celiac disease than we do about NCGS, the mechanism of the latter being more difficult to classify. There are specific antibody tests for celiac disease diagnosis and there is also the endoscopy/biopsy of the small bowel lining. Currently, there are no tests to diagnose NCGS. Celiac disease must first ruled out. Researchers are working on developing testing methods to diagnose celiac disease that do not require a "gluten challenge" which is just out of the question for so many because it poses serious, even life-threatening, health risks. But we aren't there yet.
    • lalan45
      That’s really frustrating, I’m sorry you went through that. High fiber can definitely cause sudden stomach issues, especially if your body isn’t used to it yet, but accidental gluten exposure can feel similar. Keeping a simple food/symptom journal and introducing new foods one at a time can really help you spot patterns. You’re already doing the right things with cleaning and separating baking—also watch shared toasters, cutting boards, and labels like “may contain.”
    • Russ H
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    • Scott Adams
      First, please know that receiving two diagnoses at once, especially one you've never heard of, is undoubtedly overwhelming. You are not alone in this. Your understanding is correct: both celiac disease and Mesenteric Panniculitis (MP) are considered to have autoimmune components. While having both is not extremely common, they can co-occur, as chronic inflammation from one autoimmune condition can sometimes be linked to or trigger other inflammatory responses in the body. MP, which involves inflammation of the fat tissue in the mesentery (the membrane that holds your intestines in place), is often discovered incidentally on scans, exactly as in your case. The fact that your medical team is already planning follow-up with a DEXA scan (to check bone density, common after a celiac diagnosis) and a repeat CT is a very proactive and prudent approach to monitoring your health. Many find that adhering strictly to the gluten-free diet for celiac disease helps manage overall inflammation, which may positively impact MP over time. It's completely normal to feel uncertain right now. Your next steps are to take this one day at a time, focus on the gluten-free diet as your primary treatment for celiac, and use your upcoming appointments to ask all your questions about MP and what the monitoring plan entails. This dual diagnosis is a lot to process, but it is also the starting point for a managed path forward to better health. This article has some detailed information on how to be 100% gluten-free, so it may be helpful (be sure to also read the comments section.):    
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