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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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    • trents
      I assume that you already know that genetic testing for celiac disease cannot be used to confirm a celiac diagnosis. About 40% of the general population has the genetic potential to develop celiac disease but only about 1% actually develop celiac disease. It can be used to rule out celiac disease with a high degree of confidence, however, in the case where the genetic testing is negative for the genes. Until and unless you are actually diagnosed with celiac disease I would not raise this as an issue with family. However, if you are diagnosed with celiac disease through blood antibody testing and/or endoscopy with positive biopsy I would suggest you encourage first degree relatives to also purse testing because there is a significant chance (somewhere betwee 10% and almost 50%, depending on which studies you reference) that they will also have or will develop active celiac disease. Often, there are symptoms are absent or very minor until damage to the small bowel lining or other body systems becomes significant so be prepared that they may blow you off. We call this "silent celiac disease". 
    • trents
      If you were off gluten for two months that would have been long enough to invalidate the celiac blood antibody testing. Many people make the same mistake. They experiment with the gluten free diet before seeking formal testing. Once you remove gluten from the diet the antibodies stop being produced and those that are already in circulation begin to be removed and often drop below detectable levels. To pursue valid testing for celiac disease you would need to resume gluten consumption equivalent to the amount found in 4-6 slices of wheat bread daily for at least two weeks, preferably longer. These are the most recent guidelines for the "gluten challenge". Without formal testing there is no way to distinguish between celiac disease and gluten sensitivity since their symptoms overlap. However, celiac disease is an autoimmune disorder that damages the small bowel lining, not true of gluten sensitivity. There is no test available for gluten sensitivity so celiac disease must first be ruled out. By the way, elevated liver enzymes was what led to my celiac diagnosis almost 25 years ago.
    • trents
      Then it does not seem to me that a gluten-related disorder is at the heart of your problems, unless that is, you have refractory celiac disease. But you did not answer my question about how long you had been eating gluten free before you had the blood antibody test for celiac disease done.
    • Xravith
      My genetic test results have arrived - I’m homozygous for DQB1*02, meaning I have HLA-DQ2. I’ve read that this is one of the genes most strongly associated with celiac disease, and my symptoms are very clear. I’m relieved that the results finally arrived, as I was getting quite worried since my symptoms have been getting worse. Next step, blood test. What do these results imply? What should I tell my family? I’m concerned that this genetic predisposition might also affect other family members.
    • Roses8721
      Two months. In extreme situations like this where it’s clearly a smoking gun? I’m in LA so went to a very big hospital for pcp and gi and nutritionist 
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