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Chronic duodenitis and gastritis post diagnose


Onemoreceliac

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Onemoreceliac Apprentice

Hello. 

Female, 24 y

I have been diagnosed with celiac disease one year ago by endoscopy, along with bile in my stomach, antral gastritis because of bile, low vitamin D and iron deficiency.

As treatment, I followed a gluten free diet, along with supplements for vitamins deficiency, I couldn't keep a 100% low inflammatory diet for gastritis. 

Second endoscopy: my villi came back to normal 100%, so the diet worked, but my gastroenterologist still found gastritis, no more bile and now- chronic duodenitis. 

My pain is mostly on the left side of the upper abdomen, sometimes I can't even sleep at night and my life is miserable. I don't know what to do anymore, why duodenitis if I had a strict gluten free diet and  why it's so hard to treat. 

My gastroenterologist recommend me a CT scan of my abdomen and pelvis to see if it's something more, but I don't want to be exposed to radiation a second time in a year( I have done before a CT scan without dye, due to a panick attack).

I don't know what to do anymore and try anymore. Please, do you have some tips or advice? Thank you.


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trents Grand Master

Are you still consuming dairy and oats?

Have you been checked for SIBO?

trents Grand Master
(edited)

By the way, CT scans don't use radiation. Neither do MRIs This was incorrect.

Edited by trents
RMJ Mentor
1 hour ago, trents said:

By the way, CT scans don't use radiation. Neither do MRIs

CT scans DO use radiation.  MRIs don’t.

trents Grand Master

Yes, you are correct RMJ. As soon as I posted that I thought to look it up and saw that I was incorrect. I thought I deleted it but I guess I failed in that.

Onemoreceliac Apprentice
3 hours ago, trents said:

Are you still consuming dairy and oats?

Have you been checked for SIBO?

Yes, I am consuming dairy and gluten free oats. I did not get checked for SIBO..

trents Grand Master
(edited)

Even though your oats are gluten free, cross contamination with wheat may no be the issue. About 10% of celiacs cannot tolerate the main protein in oats, avenin, which causes them to react in the same way as they do to gluten in wheat.

Also, it is very common for celiacs to be dairy intolerant. It can be caused by the sugar in milk (lactose) or a protein in milk (casein). Casein is known to blunt villi just like gluten for some celiacs.

SIBO is pretty common in celiacs.

Edited by trents

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Onemoreceliac Apprentice
6 minutes ago, trents said:

Even though your oats are gluten free, cross contamination with wheat may no be the issue. About 10% of celiacs cannot tolerate the main protein in oats, avenin, which causes them to react in the same way as they do to gluten in wheat.

Also, it is very common for celiacs to be dairy intolerant. It can be caused by the sugar in milk (lactose) or a protein in milk (casein). Casein is known to blunt villi just like gluten for some celiacs.

SIBO is pretty common in celiacs.

Ok, thank you for your answer. I will get tested for lactose intolerance and Sibo and maybe one of them is the cause for my bile reflux. 

trents Grand Master

It might be more practical and less expensive to just trial elimination of oats and dairy for a period of time and see if your symptoms improve. SIBO, however, would likely call for antibiotics in the short term and dietary adjustments in the long run.

Onemoreceliac Apprentice
1 minute ago, trents said:

It might be more practical and less expensive to just trial elimination of oats and dairy for a period of time and see if your symptoms improve. SIBO, however, would likely call for antibiotics in the short term and dietary adjustments in the long run.

Ok, I ll try it. 

trents Grand Master

By the way, are you on some kind of acid blocking medication?

Onemoreceliac Apprentice
1 minute ago, trents said:

By the way, are you on some kind of acid blocking medication?

Yes, I took them because my Dr recommend it, but not even a bit of improvement and I stopped them. I don't know if my stomach has too much acid or to little. Nothing seems to work. Also, on the internet are a lot of contradictory information regarding the diet for bile reflux and gastritis-duodenitis (eg: apple is good for binding bile out of the stomach, but bat for gastritis). Regarding the oats, I took them for about 1-2 months because it says it's helpful for binding the bile.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

trents Grand Master

https://www.mayoclinic.org/diseases-conditions/bile-reflux/diagnosis-treatment/drc-20370121

Lifestyle and home remedies

Unlike acid reflux, bile reflux seems unrelated to lifestyle factors. But because many people experience both acid reflux and bile reflux, your symptoms may be eased by lifestyle changes:

Stop smoking. Smoking increases the production of stomach acid and dries up saliva, which helps protect the esophagus.

Eat smaller meals. Eating smaller, more-frequent meals reduces pressure on the lower esophageal sphincter, helping to prevent the valve from opening at the wrong time.

Stay upright after eating. After a meal, waiting two to three hours before lying down allows time for your stomach to empty.

Limit fatty foods. High-fat meals relax the lower esophageal sphincter and slow the rate at which food leaves your stomach.

Avoid problem foods and beverages. Some foods increase the production of stomach acid and may relax the lower esophageal sphincter. Foods to avoid include caffeinated and carbonated drinks, chocolate, citrus foods and juices, vinegar-based dressings, onions, tomato-based foods, spicy foods, and mint.

Limit or avoid alcohol. Drinking alcohol relaxes the lower esophageal sphincter and irritates the esophagus.

Lose excess weight. Heartburn and acid reflux are more likely to occur when excess weight puts added pressure on your stomach.

Raise your bed. Sleeping with your upper body raised 4 to 6 inches (10 to 15 centimeters) may help prevent reflux symptoms. Raising the head of your bed with blocks or sleeping on a foam wedge is more effective than is using extra pillows.

Relax. When you're under stress, digestion slows, possibly worsening reflux symptoms. Relaxation techniques, such as deep breathing, meditation or yoga, may help.

Onemoreceliac Apprentice

Thank you so much.

Posterboy Mentor

Onemoreceliac,

Your symptom's can be explained by Low/NO Stomach Acid being misdiagnosed.

Low Iron can be caued by Low/NO Stomach Acid and it is often overlooked.

See this article entitled "Is achlorhydria a cause of iron deficiency anemia?"

The answer was a resounding yes! it could be and it (IDA) is being caused by too low a stomach acid!

https://academic.oup.com/ajcn/article/102/1/9/4564242

The

On 9/4/2022 at 3:39 AM, Onemoreceliac said:

My pain is mostly on the left side of the upper abdomen, sometimes I can't even sleep at night and my life is miserable

Could be from an Ulcer.....

Here is a nice article that will give you other options if you don't think it could be an ucler....

https://patient.info/signs-symptoms/left-upper-quadrant-pain-leaflet

Howard Hughe Medical Institute aka HHMI did a nice article about why Ulcers develop from Low Stomach Acid instead of the High Stomach Acid you often hear about...

https://www.hhmi.org/news/excessive-growth-bacteria-may-also-be-major-cause-stomach-ulcers

Sleeping your left side might help your Heartburn/GERD.

Here is a  nice article about it......called advances in GERD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886414/

I hope this is helpful but it is not medical advice.

I wrote Posterboy blog post about why and how some low/NO stomach acid can be confused for NCGS and/or Celiac disease it might help you to read it.

Good luck on your continued journeys in life!

2 Timothy 2:7 Consider what I say; and the Lord give thee understanding in all things.

Posterboy by the Grace of God,

Onemoreceliac Apprentice
5 hours ago, Posterboy said:

Onemoreceliac,

Your symptom's can be explained by Low/NO Stomach Acid being misdiagnosed.

Low Iron can be caued by Low/NO Stomach Acid and it is often overlooked.

See this article entitled "Is achlorhydria a cause of iron deficiency anemia?"

The answer was a resounding yes! it could be and it (IDA) is being caused by too low a stomach acid!

https://academic.oup.com/ajcn/article/102/1/9/4564242

The

Could be from an Ulcer.....

Here is a nice article that will give you other options if you don't think it could be an ucler....

https://patient.info/signs-symptoms/left-upper-quadrant-pain-leaflet

Howard Hughe Medical Institute aka HHMI did a nice article about why Ulcers develop from Low Stomach Acid instead of the High Stomach Acid you often hear about...

https://www.hhmi.org/news/excessive-growth-bacteria-may-also-be-major-cause-stomach-ulcers

Sleeping your left side might help your Heartburn/GERD.

Here is a  nice article about it......called advances in GERD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886414/

I hope this is helpful but it is not medical advice.

I wrote Posterboy blog post about why and how some low/NO stomach acid can be confused for NCGS and/or Celiac disease it might help you to read it.

Good luck on your continued journeys in life!

2 Timothy 2:7 Consider what I say; and the Lord give thee understanding in all things.

Posterboy by the Grace of God,

Thank you. How can I test my stomach acid levels? In my country I never heard about a test like that. I heard about a test at home with baking soda and water, but it is accurate or safe?

 

 

trents Grand Master

Yes, try the home test with baking soda and water. It is not precise but will be "in the ballpark" (an American expression) and tell you basically what you need to know. Yes, it is safe to do occasionally. Lots of sodium so you don't want to do it frequently.

  • 2 years later...
Barcino Rookie
On 9/4/2022 at 3:39 AM, Onemoreceliac said:

Hello. 

Female, 24 y

I have been diagnosed with celiac disease one year ago by endoscopy, along with bile in my stomach, antral gastritis because of bile, low vitamin D and iron deficiency.

As treatment, I followed a gluten free diet, along with supplements for vitamins deficiency, I couldn't keep a 100% low inflammatory diet for gastritis. 

Second endoscopy: my villi came back to normal 100%, so the diet worked, but my gastroenterologist still found gastritis, no more bile and now- chronic duodenitis. 

My pain is mostly on the left side of the upper abdomen, sometimes I can't even sleep at night and my life is miserable. I don't know what to do anymore, why duodenitis if I had a strict gluten free diet and  why it's so hard to treat. 

My gastroenterologist recommend me a CT scan of my abdomen and pelvis to see if it's something more, but I don't want to be exposed to radiation a second time in a year( I have done before a CT scan without dye, due to a panick attack).

I don't know what to do anymore and try anymore. Please, do you have some tips or advice? Thank you.

I know this post is old but was wondering if you ever resolved this. My son is in the same situation. Villi healed but gastritis / duodenitis remain and calprotectin elevated. Now testing for crohns which I am freaking out about. 

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      Currently, there are no tests for NCGS. Celiac disease must first be ruled out and we do have testing for celiac disease. There are two primary test modalities for diagnosing celiac disease. One involves checking for antibodies in the blood. For the person with celiac disease, when gluten is ingested, it produces an autoimmune response in the lining of the small bowel which generates specific kinds of antibodies. Some people are IGA deficient and such that the IGA antibody tests done for celiac disease will have skewed results and cannot be trusted. In that case, there are IGG tests that can be ordered though, they aren't quite as specific for celiac disease as the IGA tests. But the possibility of IGA deficiency is why a "total IGA" test should always be ordered along with the TTG-IGA. The other modality is an endoscopy (scoping of the upper GI track) with a biopsy of the small bowel lining. The aforementioned autoimmune response produces inflammation in the small bowel lining which, over time, damages the structure of the lining. The biopsy is sent to a lab and microscopically analyzed for signs of this damage. If the damage is severe enough, it can often be spotted during the scoping itself. The endoscopy/biopsy is used as confirmation when the antibody results are positive, since there is a small chance that elevated antibody test scores can be caused by things other than celiac disease, particularly when the antibody test numbers are not particularly high. If the antibody test numbers are 10x normal or higher, physicians will sometimes declare an official diagnosis of celiac disease without an endoscopy/biopsy, particularly in the U.K. Some practitioners use stool tests to detect celiac disease but this modality is not widely recognized in the medical community as valid. Both celiac testing modalities outlined above require that you have been consuming generous amounts of gluten for weeks/months ahead of time. Many people make the mistake of experimenting with the gluten free diet or even reducing their gluten intake prior to testing. By doing so, they invalidate the testing because antibodies stop being produced, disappear from the blood and the lining of the small bowel begins to heal. So, then they are stuck in no man's land, wondering if they have celiac disease or NCGS. To resume gluten consumption, i.e., to undertake a "gluten challenge" is out of the question because their reaction to gluten is so strong that it would endanger their health. The lining of the small bowel is the place where all of the nutrition in the food we consume is absorbed. This lining is made up of billions of microscopically tiny fingerlike projections that create a tremendous nutrient absorption surface area. The inflammation caused by celiac disease wears down these fingers and greatly reduces the surface area needed for nutrient absorption. Thus, people with celiac disease often develop iron deficiency anemia and a host of other vitamin and mineral deficiencies. It is likely that many more people who have issues with gluten suffer from NCGS than from celiac disease. We actually know much more about the mechanism of celiac disease than we do about NCGS but some experts believe NCGS can transition into celiac disease.
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