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Unclear Diagnosis and Lactose


mrsfunkway

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mrsfunkway Rookie

Hello,

Around the end of October I was diagnosed with Celiac after the GI doc did an endoscopy and found evidence of flattened villi. So I have been gluten-free since then. However just before Christmas, I had a follow up with the GI dr and he said my biopsies came back negative for Celiac? He said if I haven't felt better I could stop the gluten-free diet. But since signs of improvement don't really show up until about 6 months (is that true?) I've decided to stay gluten-free until April or May just to see.

However, a week ago I started feeling really ill whenever I ate. 95% of my meals were not in danger of gluten or CC as I prepared them at home. But then I think I finally realized the common theme with my meals - dairy. The first meal that made me sick had a greek yogurt sauce, a slimfast shake had milk in it, ranch dressing with some buffalo wings, and a corn tortilla quesadilla. Nausea, getting really warm, nearly immediate gastric dumping, etc. I thought I had gotten the The reason I say "I think I finally realized" is because it would be an awful intensely sensitive lactose intolerance - I'm getting a similar yet weaker reaction to < tsp of butter and possibly milk in baked goods. Which might also explain why my probiotics haven't helped ("may contain traces of dairy"). I also can't eat a lot of rice at the moment because it causes diarrhea. 

Can lactose intolerance really be that severe? Could it be caused by my possible Celiac dx or something else? I had also been dx'd with severe gastritis. The acid reducers have helped with some of those symptoms (abdominal tenderness/cramping). This whole diet change has caused a whole lot of stress and sadness. Rice and cheese were my big staples once gluten was cut out. And now I can't even eat them without distress! :(


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Zodi1993 Apprentice

Hi Mrsfunkway, 

I might suggest getting tested for EOE. It's a biopsy done by your GI doctor. If you test positive then it basically involves eliminating 6  major allergies, milk, eggs, wheat, soy, peanuts/tree nuts and seafood (fish/shellfish) from your diet. My daughter has Celiac Disease and is allergic to wheat, yeast, shrimp and sesame seeds. Her acid was so bad that she was afraid to eat. After her EoE diagnosis she has cutback on most of her dairy (almond milk is a good alternative) and eggs. She does take a Gerd medicine that was prescribed by her allergist 20 minutes twice a day prior to eating. It seems to be helping and she has been trying to increase her niacin as that helps with burping. 

The EOE is was a shock but yeast seems to be the hardest thing to remove from her diet. It's more of a trial and error process and keeping a food diary or log is extremely helpful in pin pointing what triggers your acid. 

Welcome to the forum ?

ravenwoodglass Mentor

It is not uncommon for folks with celiac to have nasty problems with dairy until they heal. The tips of the villi create the enzyme that helps us digest dairy and when celiac damages those tips dairy will cause issues.  Many are able to add dairy back in after they heal. I was happy to be one of those. there are some, however that react to the protein (casien) rather than the sugar (lactose) and I think they may be less likely to be able to do dairy products.  When you have healed you can try adding dairy back in starting with hard cheeses like cheddar.

cyclinglady Grand Master

What?  You had positive a positive celiac blood test, positive endoscopy (your GI said that visually it looks like celiac disease), but your biopsies were negative.  The small intestine when stretched out is vast.  So easy to miss damaged areas.  Your GI knows this, but from my research GI's do not want to diagnose unless they see Damage in the biopsies.  I guess they think that giving up gluten is too horrible to contemplate!  

Consider staying the course (gluten-free diet) and give up dairy for now.  Those wings?  Ugh!  Way to spicy for me when my gut is not healed!  That is just one example.  Stick with simple Whole Foods until you see progress.  

Yes, a lactose intolerance could cause those symptoms.  So could gluten and other foods like corn or soy.  Look to your diet.  In the beginning it is easy to get gluten exposures.  A gluten-free diet has a huge learning curve.  Remember, it takes most of us up to a year to heal.  We all experience set-backs along the way.  

Ask your GI to re measure your antibodies to see if the diet is helping.  That can be very telling.  

Finally, grief is normal.  celiac disease sucks!  So, expect to go through the classic levels of grieving.  It is normal!  But I can tell you it does get better!  

Hugs!  

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    • trents
      So the tTG-IGA at 28 is positive for celiac disease. There are some other medical conditions that can cause elevated tTG-IGA but this is unlikely. There are some people for whom the dairy protein casein can cause this but by far the most likely cause is celiac disease. Especially when your small bowel lining is "scalloped". Your Serum IGA 01 (aka, "total IGA") at 245 mg/dl is within normal range, indicating you are not IGA deficient. But I also think it would be wise to take your doctor's advice about the sucraid diet and avoiding dairy . . . at least until you experience healing and your gut has had a chance to heal, which can take around two years. After that, you can experiment with adding dairy back in and monitor symptoms. By the way, if you want the protein afforded by dairy but need to avoid casein, you can do so with whey protein powder. Whey is the other major protein in dairy.
    • jenniber
      hi, i want to say thank you to you and @trents   . after 2 phone calls to my GI, her office called me back to tell me that a blood test was “unnecessary” and that we should “follow the gold standard” and since my biopsy did not indicate celiac, to follow the no dairy and sucraid diet. i luckily have expendable income and made an appt for the labcorp blood test that day. i just got my results back and it indicates celiac disease i think 😭   im honestly happy bc now i KNOW and i can go gluten free. and i am SO MAD at this doctor for dismissing me for a simple blood test that wouldn’t have cost her anything !!!!!!!!!!! im sorry, im so emotional right now, i have been sick my whole life and never knew why, i feel so much better already   my results from labcorp:   Celiac Ab tTG TIgA w/Rflx Test Current Result and Flag Previous Result and Date Units Reference Interval t-Transglutaminase (tTG) IgA 01 28 High U/mL 0-3 Negative 0 - 3 Weak Positive 4 - 10 Positive >10 Tissue Transglutaminase (tTG) has been identified as the endomysial antigen. Studies have demonstrated that endomysial IgA antibodies have over 99% specificity for gluten sensitive enteropathy. Immunoglobulin A, Qn, Serum 01 245 mg/dL 87-352
    • JoJo0611
      Thank you this really helped. 
    • Samanthaeileen1
      Okay that is really good to know. So with that being positive and the other being high it makes sense she diagnosed her even without the endoscopy. So glad we caught it early. She had so many symptoms though that to me it was clear something was wrong.   yeah I think we had better test us and the other kids as well. 
    • GlorietaKaro
      One doctor suggested it, but then seemed irritated when I asked follow-up questions. Oh well—
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