Positive Ttg IgA and mild villous blunting

[Sarah910]

My son has been having ongoing investigations for coeliac disease. We have a family history and he has abdominal pain, bloating, mucus stools, headaches and joint pain (all of which come and go). He has had 3 separate blood tests- first showed ttg IgA of 8.1, second 5.9 (at time of endoscopy) and third 6.5 (I believe normal is 0-4.9). 
 

We have spoken with GI paediatrician who has labelled him ‘possible coeliac’ and ran lots of further tests to rule out conditions that’s could cause these symptoms (crohn’s, arthritis, helicobacter etc). 
 

when we got results of endoscopy they said it was normal but we have had the report through on paper and it states mild degree of villous blunting but with absence of intraepithelial lymphocytes.

consultant wants to explore SIBO before gluten free. 

my question is, I am aware SIBO can cause mild villous atrophy and gi symptoms but would it account for joint pain and headaches? Also the 3 positive Ttg IgA’s? 

thoughts and advice welcomed.

 

[Scott Adams]

I find it very strange that his doctor appears to be ignoring multiple positive blood tests for celiac disease AND biopsy results which seem to confirm celiac disease. The varied symptoms you've described are very typical for celiac disease, so my only question is, why has your doctor not started him on a gluten-free diet at this point?! Symptom relief would be the final confirmation that he has it.

[Sarah910]

6 minutes ago, Scott Adams said:

I find it very strange that his doctor appears to be ignoring multiple positive blood tests for celiac disease AND biopsy results which seem to confirm celiac disease. The varied symptoms you've described are very typical for celiac disease, so my only question is, why has your doctor not started him on a gluten-free diet at this point?! Symptom relief would be the final confirmation that he has it.

He seems to want to explore other options as feels there’s not clear enough markers? I disagree. He started talking about NCGS as well but I dismissed that as NCGS does not cause elevated IgA. 
So I’m right that SIBO wouldn’t cause positive IgA? 
he spoke a lot about kids like my son who 50% go on to develop coeliac but 50% don’t..? 

[Scott Adams]

As far as I know, SIBO would not cause a single positive ttg IgA test, let alone several. One test was nearly double the marker for celiac disease--this is a very specific test that can't really be explained by very much else, especially given his symptoms AND biopsy findings.